ACR Economics and Health Policy focuses on issues related to how radiologists and radiation oncologists are reimbursed for their services under the guidance of the Commission on Economics.
Imaging 3.0

Imaging 3.0™

Imaging 3.0 is a change process being led by the ACR for the field of radiology. It includes a set of technology tools that equip 21st-century radiologists to ensure their key role in evolving health care delivery and payment models—and quality patient care.

New case study posted on 8/28/14


Billing and Coding

Billing & Coding

ACR Economics and Health Policy staff submits code recommendations to the CPT® Editorial Panel for the coding manual for diagnostic radiology, radiation oncology and nuclear medicine.

Managed Care and Private Payer

Managed Care & Private Payer resources help ACR members deal effectively with managed care organizations. We evaluate trends in payer behavior and philosophy and educate payers, patients and hospitals about the value of diagnostic and therapeutic radiology in providing cost-effective medical care.

Medicare Payment Systems

Medicare Payment Systems

Medicare uses the Medicare Physician Fee Schedule (MPFS) to reimburse for physician services. CMS publishes proposed and final rules each year that addresses certain provisions and changes to Medicare Part B payment policy.

Medicaid

The Medicaid program is administered by states within broad federal regulations and is financed jointly by the federal government and states. Under the Affordable Care Act, 26 states and the District of Columbia have taken advantage of federal subsidies and opted to expand Medicaid eligibility leading to a dramatic increase in Medicaid enrollment. The ACR monitors Medicaid programs and reviews local coverage policies.

Clinical Decision Support

The ACR has an exclusive agency agreement with the National Decision Support Company (NDSC) to provide the technical platform, support and licensing of its copyrighted appropriateness criteria under the name ACR Select. The College urges members, ordering physicians and administrative members to learn how ACR Select, a computer-based diagnostic imaging decision support system that uses ACR Appropriateness Criteria®, operates.

Coverage

The ACR Radiology, Radiation Oncology, and Nuclear Medicine Carrier Advisory Committee (CAC) Network Representatives advocate on behalf of radiology and all radiology subspecialties for fair reimbursement policies at the local Medicare level. By reviewing and commenting on Local Coverage Decisions (LCDs) and policy changes before they are implemented, the CAC networks help ensure members are appropriately reimbursed for medically reasonable and necessary services provided to Medicare patients.