ACR Committee Tackles Local Medicare Coverage Policies at ACR 2024

The American College of Radiology® (ACR®) Contractor Advisory Committee (CAC) Network, convened at ACR 2024, the College’s annual meeting to reflect on 2023 local coverage successes, challenges, and anticipated important issues.

Chaired by Sammy Chu, MD, FACR, and Laeton Pang, MD, FACR, the CAC network consists of more than 140 appointed representatives and alternates. The network identifies, reviews and comments on draft local Medicare coverage determination policies (LCD) and associated billing and coding articles to help identify the best interests of the radiology community and ensure the implementation of appropriate policies. Attendees discussed local coverage successes and challenges and participated in an open forum to reflect on multijurisdictional CAC meetings and engagement with contractor medical directors during the past year. Key topics for 2024 include final policies for Trigger Point Injections, Sacroiliac Joint Interventions, and updated coding guidance for CT Perfusion Analysis. The CAC also will continue to monitor the implementation of Amyloid PET imaging reimbursement now that Medicare Administrative Contractors (MACs) have the discretion to extend coverage and payment to Medicare beneficiaries.

ACR CAC leaders and our Multi-Specialty CAC Engagement Coalition will meet soon with the Centers for Medicare and Medicaid Services (CMS) leadership to discuss further improvements needed to the LCD process and its effects on our professions.

CMS relies on a network of MACs to develop local coverage determinations and engage with CAC representatives. The purpose of the CAC is to provide a formal mechanism for healthcare professionals to be informed of the evidence used in consideration of a proposed LCD and to promote communications between the MAC and the healthcare community. The ACR CAC Network structure and activities are essential to develop sound local coverage policies that enhance our profession and the impact we have on patient care.

During the meeting, ACR presented certificates of achievement to CAC representatives who completed the second year of the ACR CAC Mentorship program. The ACR is appreciative of the CAC network’s dedicated physician, society staff, and business manager volunteers for their advocacy for appropriate reimbursement for medically reasonable and necessary services provided to Medicare patients. ACR continually seeks active health policy advocates to advance the radiology profession’s work.

If you have questions or would like more information about local coverage policies and activities, visit the ACR CAC website or contact Alicia Blakey, ACR Principal Economic Policy Analyst.