December 16, 2020

ACR Prepares 2021 MPFS Final Rule Impact Tables

The American College of Radiology® (ACR®) has prepared impact tables showing that the 2021 Medicare Physician Fee Schedule (MPFS) final rule has varied effects on medical imaging payment rates for diagnostic and interventional radiology, nuclear medicine, and radiation oncology.

The tables cover specific changes in reimbursement rates between calendar years 2020 and 2021 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.

These tables reflect the 10.2% budget neutrality adjustment to the conversion factor as a result of increases in the relative value units (RVUs) for evaluation and management services. If Congress does not act to mitigate the budget neutrality cut, these impacts will remain unchanged. This conversion factor adjustment applies to all RVUs for all CPT codes, both technical and professional components. The bottom line change in reimbursement rates from 2020 to 2021 varies by CPT code. Some codes will see larger or smaller decreases based on RVU adjustments. If Congress does act to mitigate the conversion factor decrease, the ACR will release new impact tables.

The Centers for Medicare and Medicaid Services estimates that the 2020 MPFS final rule will lead to a 10% decrease for diagnostic radiology, while interventional radiology would see an aggregate decrease of 8%, nuclear medicine an 8% decrease, and radiation oncology and radiation therapy centers a 5% decrease.

Please direct questions on the MPFS impacts to Katie Keysor, ACR Senior Director of Economic Policy.