More Pay Cuts Proposed for 2013

Expansion of the Multiple Procedure Payment    Reduction (MPPR) to the professional component (PC) of advanced imaging services has negatively affected radiology group revenues nationwide.  2013’s proposed physician’s fee schedule does not allow for any more relief for radiologists.  Most multispecialty practices can expect at least a 1% change in pay from the Relative Value Unit (RVU).  Specialties who rely on lab or imaging services, such as pathology or thoracic surgery will realize the 1% decrease.  Overall, radiation oncology expects a 14% cut and radiation therapy a 19% cut.  These reductions will be felt even more with close to 30% on the chopping block due to the delayed cuts from the SGR, which will expire January 1^st, 2013.  

The proposed physician fee schedule also includes expansion of the MPPR to previously untouched codes.  These codes are most widely utilized by Cardiology (75600-75893, 78414-78496) and Ophthalmology (76510-76529, 92002-92371), but are billed by many Radiology groups also. According to Dr. Paul Ellenbogen, chair of the American College of Radiology’s Board of Chancellors, group practices will no longer receive full reimbursement for the PC of multiple imaging interpretations of tests read by different providers for the same patient on the same day.  This will affect providers of trauma, heart attack and cancer patients the most, but it is not uncommon to order CT scans of the head, chest and abdomen, which are then analyzed by providers in the same practice or hospital.  APS will keep you up to date with all proposed payment rules as they move forward.  If you have any immediate questions, please contact your account representative at APS.