ACR says policy change will cost imaging field $10B without congressional action

The American College of Radiology estimates a Medicare policy change will cost the imaging field $770 million in the first year of implementation alone, and $10 billion over the next decade.

ACR made that discovery after recently hiring the Moran Company to analyze future payment trends, following the feds’ decision to increase reimbursement for care-related Evaluation and Management (E/M) services by about $5 billion. In a budget-neutral world, that boost means cuts to pay for radiologists and other providers who do not typically use such codes.

The college and dozens of other specialties reached out to leaders in the House and Senate in March, asking for the suspension of budget neutrality to help physicians already walloped by COVID’s economic impact.

“The findings [of the new Moran Co.] analysis reinforce the ACR’s recent message to Congress about the significant negative consequences the impending 2021 CMS E/M policy will have on radiologists and other medical providers that do not frequently bill E/M services,” the college said in a news item shared Wednesday.  

California would suffer the largest financial hit, the study found, with a roughly $88 million decrease in imaging pay the first year, followed by Florida (almost $74.7 million) and New York ($69.4 million). The analysis covers all Medicare outpatient imaging services, regardless of specialty. Officials are sharing the findings with lawmakers, according to the news post, while also asking state chapters to reach out to their own representatives.

Absent any action, the policy change is set to take effect on Jan. 1, 2021. Others signing the most recent letter to congressional leaders include the American Society for Radiation Oncology, the Association for Quality Imaging, the Radiology Business Management Association, and the Society of Interventional Radiology.