July 22, 2016

ACR Finds Mixed Impacts in 2017 MPFS Proposed Rule

An analysis by the American College of Radiology (ACR) has found the proposed rule for the Calendar Year (CY) 2017 Medicare Physician Fee Schedule (MPFS) would have varied effects on payment rates for diagnostic and interventional radiology, radiation oncology and nuclear medicine procedures.

The Centers for Medicare & Medicaid Services (CMS) estimates the proposal would lead to an overall one percent decrease to diagnostic radiology services, an estimated seven percent reduction to interventional radiology, and no estimated change to reimbursement for radiation oncology and nuclear medicine services. However, specific impacts vary widely and could contribute to either increased or decreased payment rates for specific services.

The proposed values for many radiology CPT codes would increase due to the inclusion of practice expense inputs for the professional PACS workstation valued at $14,616.93. On the other hand, decreased values have been proposed for several CPT codes due to CMS’ ongoing efforts to identify misvalued codes and to pursue code bundling initiatives.

ACR staff has prepared impact tables to show the specific proposed change in reimbursement rates between 2016 and 2017 for each Current Procedural Terminology® (CPT) code. The analysis includes one 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.

We are continuing to analyze the proposed rule for extensive comments that will be submitted to CMS by its September 6 deadline.

View Table 1 (impacts for the 70,000 series CPT codes)
View Table 2 (impacts for the non-70,000 series CPT codes)

ACR members also have access to a detailed report from our economics staff that summarizes the CY 2017 Medicare Physician Fee Schedule Proposed Rule.