X-ray Reimbursement Cuts on the Horizon for Film

Film vs. Digital

Medicare x-ray reimbursement cuts on the horizon

 

In December 2015 President Obama signed the Consolidated Appropriations Act of 2016. Included in the 2000-page document is a special rule for diagnostic radiology that incents imaging providers to adopt more advanced x-ray technology by cutting reimbursement to older technology beginning in 2017.

Medicare cuts to imaging’s ‘bread and butter’

The new legislation imposes reimbursement cuts to the technical component for x-rays performed on older technology. The reductions apply to both the Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS).

Beginning in 2017, claims submitted for x-rays performed on analog equipment will receive a 20% reduction in payment. As most organizations replaced analog equipment, this will likely impact a relatively small number of providers.

But while few providers still use analog x-rays, some organizations replaced these units with computed radiography (CR), defined as cassette-based imaging, before digital radiography was widely available. Beginning in 2018, claims for x-rays performed using CR technology will be reduced by 7%. The cuts will increase to 10% beginning in 2023.

Based on IMV Medical Information Division’s 2015 X-ray Market Report, there are more than 8,000 CR x-rays still in use. We anticipate CMS will create a modifier to ensure that cuts only apply to claims using these older technologies, similar to the XR-29 regulation.