What the typical radiology practice can expect in pay following 2021 Medicare fee schedule updates

As the dust settles from Congress’ last-minute act to shield radiologists from Medicare pay cuts, experts this week offered advice on what these new numbers mean for the typical imaging practice.

Following adjustments from the Consolidated Appropriations Act, 2021’s final conversion factor will land at $34.89, a 3.3% drop from the previous year, consulting firm Healthcare Administrative Partners reported Monday. That’s compared to cuts as high as 11% before congressional action and is attributed to the elimination of code G2211 for complex visits.

HAP estimated that professional component fees will drop between 3%-5% for the most common procedures, but global fees will see increases and decreases across a broader range. To help determine the precise impact from these changes at each practice, the Media, Pennsylvania-headquartered firm recommended conducting a volume-weighted analysis, utilizing data from the previous year.

VP of Client Services Sandy Coffta estimated that a typical full-service practice might see a roughly 4.24% decrease in the professional component of reimbursement, and a 1.78% drop in global reimbursement.

“These results depend on the mix of modalities and the volume performed for each procedure,” she wrote Jan. 25. “The final analysis for any individual practice will depend on its structure (hospital-based professional component versus global imaging center billing) and its mix of modalities.”

You can read more of her analysis from HAP’s Radiology Billing and Coding Blog below.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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