Medicare spending on diagnostic radiology services fell $890M below expected levels in 2020

Medicare spending on diagnostic radiology services fell $890 million (16%) below expected levels in 2020, according to new data from the American Medical Association released Thursday.

Overall, the drop was $13.9 billion across all physician services in the federal payment program, with actual spending falling below projections regardless of service type, setting, specialty or region. The COVID-19 pandemic has taken a sizable bite out of physicians’ finances, and the AMA is now underlining this reality hoping to convince the feds not to reduce reimbursement further.

“Medical practices that have not buckled under financial strain continue to be stretched clinically, emotionally and fiscally as the pandemic persists,” association President Gerald Harmon, MD, said in a statement. “Yet physicians face an array of planned cuts that would reduce Medicare physician payments by nearly 10% for 2022.”

Diagnostic radiology saw one of the highest dollar-figure shortfalls compared to projections, behind only ophthalmology ($1 billion) and physical therapy ($1.2 billion). Interventional radiology’s 2020 total was about $21 million (4%) behind expectations, the AMA reported, while radiation oncology landed $154 million short (8%).

The drops came despite a mid-year rebound after “sharp” declines in early 2020. Some specialties did see marked upticks in telehealth spending to help offset some of these shortfalls, but diagnostic radiology was not one of them. Overall, telemedicine accounted for 5% of spending in the Medicare Physician Fee Schedule last year compared to 0.1% prior to the pandemic.

Non-urgent care shutdowns over the spring and summer of 2020 were the primary cause of the spending declines in imaging, the American College of Radiology said Thursday. Cancer screenings plummeted during that period, and it is still yet to be seen whether this will lead to an increase in cancer deaths.

“The ACR will protect patient access to imaging care and their chosen providers by continuing to stand against Medicare payment cuts and profit-driven insurer efforts to artificially reduce imaging costs such as the current implementation of the No Surprises Act,” the college said in a statement.

AMA compiled the report based on quarterly Medicare Carrier Standard Analytic Files for 2019 and 2020. You can read more about the findings and methodology here.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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