August 21, 2019

ACR Prepares 2020 MPFS Proposed Rule Impact Tables

The American College of Radiology (ACR) has prepared impact tables showing the 2020 Medicare Physician Fee Schedule (MPFS) proposed rule would have varied effects on medical imaging payment rates if accepted without modification for diagnostic and interventional radiology, nuclear medicine and radiation oncology.

The tables cover specific changes in reimbursement rates between calendar years 2019 and 2020 for each Current Procedural Terminology® (CPT) code. The ACR analysis includes a spreadsheet for the 70,000 series CPT codes and another spreadsheet for the non-70,000 CPT codes that are billed by radiologists, interventional radiologists and/or radiation oncologists.

The Centers for Medicare and Medicaid Services (CMS) estimates that acceptance of the 2020 MPFS proposed rule would lead to a net overall one percent rate decrease for radiology, a two percent decrease for interventional radiology, a one percent increase to nuclear medicine and a neutral zero percent for radiation oncology and therapy centers. However, specific impacts vary widely for specific modalities and include either payment rate increases or decreases depending upon the procedure.

Many specific code impacts are related to the CMS’ proposal to update practice expense direct inputs for supply and equipment pricing, based on market research conducted by contract with StrategyGen. In addition, CMS agreed to the physician work RVUs and practice expense inputs accepted and recommended by the AMA RVS Update Committee.