Radiology Payment Adjustments to Decrease in 2020

The U.S. Centers for Medicare and Medicaid Services (CMS) announced their revised fee schedule at the end of July, and it includes cuts in reimbursements for radiology in 2020. The proposed reductions include:

• -1% for Diagnostic Radiology
• -2% for Interventional Radiology

Nuclear medicine would see a 1% increase, however, and there is no projected change for radiation oncology and therapy centers. The proposal is currently open for comments and will likely not be finalized until November of this year.

Sites will see more significant changes in reimbursement for individual procedures. CMS is recommending 100 new and revised radiology codes for 2020, with increasing values in some, but decreasing values in 41 of those codes.

Also starting in 2020, providers must consult appropriate use criteria (AUC) when ordering CT, MRI and PET scans and nuclear medicine exams for Medicare patients.

CMS is also focusing on the Merit-based Incentive Payment System, or MIPS program, including a framework called Value Pathways. The proposed rule would also include updated pricing for 70 equipment and supply items for ultrasound and vascular ultrasound rules, and it adds language on two radiology codes (10005, 10021) that they perceive as incorrectly valued.

These changes have not yet been finalized, however, and the commend period is open until September 27^th. CMS anticipates finalizing the updated rules by November 2019.

For more information about the MagView integrated MIPS solution, click here.

Keep watching the MagView blog for further news and updates from CMS and other related news items.