CMS Proposes Cuts to X-Ray Reimbursement
Monday, July 18, 2016
Posted by: Bradley Coffey, MA, AAOE Government Affairs
On Thursday, July 7, 2016, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Physician Fee Schedule (PFS). In this proposed rule, CMS has proposed to enact Congressional cuts to reimbursements for analog (film) X-Rays. These proposed cuts will cut 20% of the technical component (TC) to reimbursements for analog X-Rays beginning in 2017. Beginning on January 1, 2017, practices submitting claims for reimbursement for analog X-Rays will be required to use modifier XX (a new modifier created by CMS specifically for this purpose) on all claims for reimbursement including when the service is billed globally.
The legislation creating this cut also included a 7% cut to X-Ray reimbursements performed using computed radiography (CR) beginning in 2018 and a 10% cut to the technical component in 2023. CMS did not release proposals to implement these cuts. These proposals will likely be included in the 2018 PFS. For purposes of the reduction, computed radiography is defined as "cassette-based imaging".
AAOE is opposed to these cuts. The Association is in contact with Congressman Tom Price's (R-GA) office regarding this policy and is working to remove these cuts. Chairman Price is the Chair of the House Budget Committee and an orthopaedic surgeon by training.
AAOE estimates that these cuts will impact approximately 68% of the X-Ray services provided by AAOE members and will result in costs, on average, of $39,354 per practice for the most common X-Ray services provided (chest X-Rays). To help AAOE improve this data, fill out the 2015 AAOE Benchmarking Report here.
To write your Members of Congress on this issue: http://bit.ly/29WmqPt
Please email AAOE Government Affairs Manager, Bradley Coffey at firstname.lastname@example.org with any questions about this issue.