ACR Responds to Medicare's Proposed Changes to the Hospital Outpatient Prospective Payment System
On July 18, Medicare released its proposal for changes to the hospital outpatient prospective payment system (HOPPS) and ambulatory payment categories (APC) for 2006. In this rule, Medicare proposes to implement the MedPAC recommendation to "reduce the technical component payment for multiple imaging services performed on contiguous body parts."
Medicare has identified 11 families of related procedures that will be subject to the proposed payment reductions. Medicare proposes to pay 100% of the technical component for the highest value procedure and 50% for any additional procedures in the same Family, when performed in the same session.
This proposed rule assumes that there are economies in the technical component when procedures in the same family are performed in the same session and that these economies are identical in all families. The ACR does not agree with these assumptions and, after a thorough review of the proposed rule, will express its concerns and comments during the formal comment period ending September 16.
The Sept-Oct 2005 issue of the ACR Radiology Coding SourceTM will provide the ACR's detailed comments to Medicare.
For a copy of the 2006 proposed HOPPS rule go to the AMA website at http://www.cms.hhs.gov/providers/hopps/2006p/1501p.asp
