ACR to Fight Double Hit on Technical Component for 2007


In order to clear up some confusion regarding the reductions in payment associated with the Medicare Physician Fee Schedule (MFS) multiple procedure discount and the Deficit Reduction Act payment cap, a summary of the relevant facts is listed below:

  1. In the 2006 MFS final rule, published in the Federal Register on November 21, 2005, the Centers for Medicare and Medicaid Services decided to phase-in their multiple procedure reduction policy over two years. They have implemented a 25 % reduction in CY 2006 and a 50 % reduction in CY 2007 to the technical component for all 11 code families (see SE0587 Medlearn Matters ) listed in their final rule.
  2. On January 1, 2007, the Deficit Reduction Act will cap payment for the technical component in a physician's office setting or a freestanding center at the lesser of the MFS payment or the ambulatory payment classification rate under the Hospital Outpatient Prospective Payment System.

As a result, if the Deficit Reduction Act payment cap and the 50 percent multiple procedure discount go into effect in 2007, there will be a double hit for radiologists in payments for the technical component. Thus, the ACR will be working this year to fight the legislation and to educate Medicare regarding this double hit for radiology. For additional background information on the DRA of 2005 and 50 percent multiple procedure discount, reference the following:

Medicare Imaging Cuts Restrict Access to Care and Discourage New Technologies Which Would Benefit Patients

Letter to Congress from James Borgstede, MD

Letter to ACR Members from James Borgstede, MD

Talking Points

Commonly Asked Questions Re the Deficit Reduction Act 2005

Impact Table by CPT Code - MS Excel

Impact Table by Modality - MS Excel