November 29, 2018

ACR Impact Tables Reveal Effects of MPFS Final Rule

The American College of Radiology (ACR) has prepared impact tables showing the 2019 Medicare Physician Fee Schedule (MPFS) final rule will have 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 2018 and 2019 for each Current Procedural Terminology® (CPT) code. The ACR analysis includes one spreadsheet for the 70,000 series CPT codes and another for the non-70,000 CPT codes that are billed by radiologists, interventional radiologists and/or radiation oncologists. ACR staff also prepared a key to assist in interpreting the tables.

The 2019 MPFS final rule estimates no net overall change for diagnostic radiology and interventional radiology and a one percent overall decrease for nuclear medicine, radiation oncology and radiation 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 Centers for Medicare and Medicaid Services’ (CMS’) update of practice expense direct inputs for supply and equipment pricing, based on market research conducted by contract with StrategyGen.

For more information, please contact Kathryn Keysor, ACR senior director of economics and health policy.