June 01, 2023

New Medicaid Reimbursement Resource for Members

A recent collaboration between the American College of Radiology® (ACR®) and the Harvey L. Neiman Health Policy Institute® (HPI) offers members a valuable resource illustrating Medicaid as a percentage of Medicare data for 10 radiology-specific Current Procedural Terminology® (CPT®) codes. Data graphics or Heat maps for all 50 states help to highlight that many states lag behind Medicare in their Medicaid reimbursement rates. To have an impact on state Medicaid programs, stakeholders must engage with the local legislatures and administration. Medicaid reimbursement is also a notoriously difficult subject to navigate since Medicaid budget has both fiscal and political pitfalls. Being able to back up arguments with recent data becomes even more important. Questions that legislators may ask include:

  • What does this mean for radiology specifically?
  • How low is the provider reimbursement exactly?
  • Does lower reimbursement potentially create obstacles to accessibility of healthcare services?

Sharing relevant state data with stakeholders and coalition partners may be able to ignite public and legislator interest in radiology reimbursement.

Read more about significant variations between the two programs in the ACR Bulletin.

For more information, contact Eugenia Brandt, ACR Senior Government Affairs Director.