Society of Interventional Radiology joins others in urging Medicare payment for high-cost disposables

The Society of Interventional Radiology and other specialties that perform catheterization procedures are seeking American Medical Association support for legislation that would provide reimbursement for medical supplies apart from the Medicare Physician Fee Schedule. 

The resolution originated from the Outpatient Endovascular and Interventional Society and the Society for Cardiovascular Angiography and Interventions. It is co-sponsored by SIR, the American Association of Clinical Urologists, American College of Cardiology, American Vein and Lymphatic Society, and the American Venous Forum.

The resolution calls for the AMA to support proposals to reform the MPFS by separately paying for certain services using supplies priced above $500, as well as those containing high-cost equipment. Resolution 115 will be proposed at the AMA House of Delegates meeting being held in Chicago June 6–11.

Reimbursement does not cover the true cost of these supplies, and annual MPFS reimbursement cuts have only exacerbated the problem. The resolution states that, in 2025, 300 nonfacility services such as those delivered at ambulatory surgery centers are paid at rates less than the direct costs associated with these procedures, according to data from the Centers for Medicare and Medicaid Services.

"The number of nonfacility services reimbursed at less than direct costs grew 50% since 2024. Because these data do not account for other costs, including indirect costs and physician work, the number of services under the MPFS for which reimbursement does not even cover cost likely is much higher than 300 services," the proposed AMA resolution states.

While ambulatory surgical centers were established to provide lower cost care than hospitals, the resolution states nonfacility services are increasingly unsustainable under the MPFS. The co-sponsoring societies said this is a catalyst for private practice closures, site-of-service reimbursement disparities, higher Medicare spending, and the need for beneficiary co-insurance as services migrate to high-cost sites of service and reduce patient access in rural geographies.

"Nonfacility services are critical to the MPFS as a lowest cost option to Medicare beneficiaries," the resolution states.

For several years, the AMA Relative Value Scale Update Committee has recommended CMS create Healthcare Common Procedure Coding System codes to identify and pay for high-cost disposable supplies priced at more than $500, but CMS has consistently declined to do so.