Industry groups oppose proposed myocardial PET cuts

When CMS released the 2020 Medicare Physician Fee Schedule (MPFS) proposed rule, it included revisions that could lead to technical component payment reductions of up to 80% for certain services related to myocardial PET scans. Five industry groups—the American College of Cardiology (ACC), American College of Nuclear Medicine (ACNM), American Society of Nuclear Cardiology (ASNC), Cardiology Advocacy Alliance (CAA) and Society of Nuclear Medicine and Molecular Imaging (SNMMI)—are now working together to voice opposition to these cuts.

“One driver of the cuts is a decision by CMS to assume a 90 percent utilization rate for PET cameras, an assumption that needs to be reconsidered,” according to a prepared statement from the five groups. “Pricing information for other equipment may also need to be further refined.”

The groups also added that these proposed changes could “lead to practice disruptions and impact patient access to PET services.”

“ACC, ACNM, ASNC, CAA and SNMMI are aggressively working to correct the inputs and calculations for the payment formula through the public comment process and communication with policymakers,” according to the prepared statement. “If it becomes clear this cannot be accomplished within the constraints of the rulemaking timeline, we will seek alternative approaches, such as a delay period, to allow further analysis and other efforts to continue.”

The groups also asked providers who have purchased PET or PET-CT imaging systems “in the past several years” to send in deidentified invoices for PET imaging cameras, PET generator infusion carts and myocardial blood flow hardware and software.

The 2020 MPFS proposed rule is available on the CMS website. Public comments are being accepted until Sept. 27.