Medicare and Medicaid Payment Systems

Current trends and activities surrounding Hospital Outpatient Prospective Payment System (HOPPS), Medicare Physician Fee Schedule (MPFS), alternative payment models and more.

MACRA and Alternative Payment Models

Understand MACRA, stay informed on its implementation, and take steps to thrive in new payment and delivery models.
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Medicare Physician Fee Schedule

CMS uses the MPFS to reimburse physician services; it is composed of resource costs associated with physician work, practice expense and professional liability insurance.
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National and Local Coverage Determinations

By reviewing and commenting on Local Coverage Decisions and proposed policy changes, the ACR Carrier Advisory Committee networks help ensure members are appropriately reimbursed for medically reasonable and necessary services provided to Medicare patients.
Learn more about coverage



Development of Resource-Based Values

The ACR is represented on the RU and submits recommendations to the AMA on radiology-related codes.
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Hospital Outpatient Prospective Payment System

CMS developed HOPPS to reimburse providers for hospital outpatient services using Ambulatory Payment Classifications.
Latest HOPPS information



Medicaid

The ACR monitors local Medicaid programs and reviews local coverage policies. In addition, our network's relationships with large, multistate Medicaid MCOs allows the ACR to have valued input in reviewing and commenting on medical coverage policies.
Additional Medicaid information



Radiology Coding Source

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Feel secure about your coding proficiency and keep up-to-date on Medicare policies with our bimonthly newsletter for radiology coding and reimbursement news.

Access the Coding Source