December 11, 2019

ACR Prepares 2020 Medicare Physician Fee Schedule Final Rule Impact Tables

The American College of Radiology® (ACR®) has prepared impact tables showing the 2020 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 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 the 2020 MPFS final rule will lead to a net overall zero percent neutral change for radiology, radiation oncology and radiation therapy centers, a one percent decrease for interventional radiology and a one percent increase to nuclear medicine. However, specific impacts vary widely for 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, the CMS agreed to the physician work relative value units and practice expense inputs accepted and recommended by the AMA RVS Update Committee.