Adjustments made by the Centers for Medicare & Medicare Services concerning room use time in 2013 have resulted in dramatically reduced reimbursements for two MRI codes: CPT code 73721 (lower extremity joint MRI) and 73221 (upper extremity joint MRI).
"To calculate [relative value units (RVUs)], Medicare estimates labor, medical supply, and equipment costs associated with every procedure," Mike Mabry, executive director of the Radiology Business Management association, told AuntMinnie.com. "For these two codes, CMS decreased its estimate of the amount of time the room would be used, from 63 minutes to 33 minutes. They cut the room time in half for those two codes, which results in lower equipment and direct costs and a lower technical component. That's why freestanding centers are seeing cuts in the range of 30 percent for these two MRI codes."
According to Rick Davis, vice president of Palm Coast Imaging in Palm Coast, Fla., the cuts are so severe that if managed care companies follow that example, freestanding centers will be hard-pressed to remain open. Article