HAP Radiology Billing and Coding Blog

A Review of the ACR’s Comments On The Medicare Physician Fee Schedule Proposed Rule For 2019

The American College of Radiology (ACR) does a very thorough job of reviewing and commenting on proposed federal legislation such as the annual changes to the Medicare Physician Fee Schedule (MPFS).  Their 59-page letter of September 10, 2019 to Seema Verma, Administrator 
of the Centers for Medicare & Medicaid Services (CMS), is available on the ACR website for radiologists to review in detail. 

Categories: radiology reimbursement, MPFS, radiology

How the Proposed Medicare Fee Schedule Changes Will Impact Radiology Practices

CMS, the Centers for Medicare and Medicaid Services, is constantly on the lookout for procedure codes that it feels do not reflect the current cost or complexity of practice in their valuation.  The annual Medicare Physician Fee Schedule (MPFS) rule modifies many codes with varying degrees of impact to radiology practices. 

Categories: radiology reimbursement, interventional radiology, MPFS, radiology

What the MPFS Proposed Rule for 2019 Means for Radiologists

The Centers for Medicare and Medicaid Services (CMS) has combined its rule making for both the Medicare Physician Fee Schedule (MPFS) and the Quality Payment Program (QPP) into one document for its 2019 proposal.  This article will summarize the elements of each area that will most affect radiology practices if they are ultimately finalized and become law later this year. 

Categories: medicare, medicare reimbursement, MPFS, Quality Payment Program, radiology, QPP

How the 2018 Coding Changes Will Affect Radiology Practices

Click here to read our 2021 code changes update article. 

 

The recently issued Medicare Physician Fee Schedule (MPFS) Final Rule for 2018 tells us which of the revisions to the Current Procedural Terminology[i] (CPT)® have been adopted for use in the Medicare system, and how Medicare values those codes.  The diagnostic radiology changes are fairly straightforward, but the Interventional Radiology (IR) coding for Endovascular Repair has been drastically altered with 20 new or revised codes. 

Categories: medicare, medicare reimbursement, interventional radiology, MPFS, CPT codes, radiology

Regulatory Changes Affecting Radiology Reimbursement in 2018

The regulations that will affect Medicare reimbursement for physician practices in 2018 have been released.  They include the Medicare Physician Fee Schedule Final Rule  (MPFS), the hospital Outpatient Prospective Payment System Final Rule (OPPS), and the Quality Payment Program Final Rule (QPP). 

Categories: medicare, medicare reimbursement, MPFS, QPP, OPPS

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 

 

Categories: radiology reimbursement, cms, MPFS, radiology

CMS Issues Its Proposed 2017 Medicare Physician Fee Schedule Rule

The Centers for Medicare and Medicaid Services (CMS) has issued its proposed revisions to the Medicare Physician Fee Schedule (MPFS) for 2017, thus beginning the annual cycle of review, comment, planning and preparation that goes along with this release.  Missing from this year’s proposed rule are provisions related to the Medicare quality reporting programs (PQRS, VM, MU-EHR*) that have been a large part of the rule in recent years. 

Categories: radiology reimbursement, MPFS

Regulatory Changes Affecting Radiology and Radiation Oncology Reimbursement in 2016

A variety of federal legislative activities during 2014 and 2015 contained rulings that will begin to affect Medicare reimbursement to physicians next year. Most recently, The Centers for Medicare and Medicaid Services (CMS) issued its Medicare Physician Fee Schedule (MPFS) Final Rule for 2016 that will govern its payments to physicians.  The overall impact of the final MPFS changes to radiology and radiation oncology practices compared with the proposed changes issued earlier this year, is estimated by CMS as follows:

 

Categories: radiology reimbursement, radiation oncology reimbursement, MPFS, value modifier, PQRS, MIPS, MACRA

How the 2016 Coding Changes will Affect Radiology Practices

The annual cycle of revising codes in the Current Procedural Terminology1 (CPT)® has been completed with the issuance of the Medicare Physician Fee Schedule (MPFS) Final Rule for 2016, and radiology is one of the areas most affected by the changes.  The traditional radiology section of codes, 70010 – 79999, has 60 additions, revisions or deletions and there are even more when the Interventional Radiology (IR) surgical codes are considered. 

Categories: radiology reimbursement, radiology coding, interventional radiology, MPFS, MRI

Medicare's Proposed 2016 Rule Changes for Radiology & Radiation Oncology

The American College of Radiology (ACR), Radiology Business Management Association (RBMA), and other similar provider advocacy organizations are busy analyzing and preparing responses to the Medicare Physician Fee Schedule (MPFS) Proposed Rule issued by the Centers for Medicare and Medicaid Services (CMS) recently.  According to the RBMA Washington Insider of July 14th, “CMS estimates that if the provisions within the proposed rule are finalized, the overall impact of the MPFS proposed changes to radiology to be 0%, while interventional radiology would see an aggregate increase of 1%, radiation oncology a decrease of 3%, nuclear medicine a change of 0%, radiation therapy centers a decrease of 9%, and Independent Diagnostic Testing Facilities (IDTFs) a 1% increase.” 

Categories: MPFS

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