December 23, 2016

CMS Summarizes 2017 MPFS Policy Changes

A MLN Matters® article MM9844 (Change Request 9844), released Dec. 16 by the Centers for Medicare & Medicaid Services (CMS), highlights the following changes to payment policies for radiology and telehealth in the calendar year (CY) 2017 Medicare Physician Fee Schedule (MPFS):

  • CT modifier reduction increase from five percent to 15 percent for CT systems not in compliance with all four attributes of the CMS XR-29 “Smart Dose” standard
  • Multiple Procedure Payment Reduction (MPPR) changed from 25 percent to five percent on the professional component (PC) of certain diagnostic procedures
  • Medicare technical component (TC) reimbursement rate cut for film X-ray procedures (See page 24 of the American College of Radiology’s detailed summary of payment provision in the CY 2017 MPFS)
  • Valuing services that include moderate sedation as an inherent part of providing the procedure (See page 20 of the ACR’s detailed summary of the CY 2017 MPFS)

For more information, see an MLN Matters® article (MM9844) and Change Request 9844. The planning and execution of CMS policies relevant to medical imaging reimbursement policies are also described in past issues of ACR Coding Source and Advocacy in Action eNews.