May 04, 2023

ACR Opposes Recent CMS Non-Coverage Decision

The American College of Radiology® (ACR®) expressed concern about the decision by the Centers for Medicare and Medicaid Services (CMS) to retroactively remove CPT® codes 0554T-0558T (biomechanical computed tomography (BCT) analysis) from the National Coverage Decision (NCD) 150.3 Bone Density Studies. These CPT codes describe services used for determining bone density using the FDA-cleared bone densitometer.

In its latest policy guidance, CMS non-covers biomechanical computed tomography (BCT) analysis retroactive to July 2019. The College seeks guidance from CMS on how healthcare providers should handle claims using these codes going forward. We believe that claims paid using these codes should not be adjusted unless there is concern that these services were not properly furnished.

The ACR and other specialty societies continue to engage with CMS to improve public notice and comment opportunities for coverage and policy articles. The change in coverage status for CPT codes 0554T-0558T retrospective to July 2019 proves existing processes are not adequate.

For questions on Medicare Coverage processes, contact Alicia Blakey, ACR Principal Economic Policy Analyst.