Radiologists struggling with MRI reimbursement cuts

Policy changes by the Centers for Medicare & Medicaid Services that resulted in MRI reimbursement cuts are dramatically affecting radiology groups, according to a recent article in Diagnostic Imaging.

As reported last month in FierceMedicalImaging, 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).

According to Mike Mabry, executive director of the Radiology Business Management Association, for the two codes, CMS decreased its estimate of the amount of time a room would be used from 63 minutes to 33 minutes, resulting in lower equipment and direct costs, as well as a lower technical component. Consequently, freestanding centers are seeing reimbursement cuts of about 30 percent for these two codes.

"Organizations and physicians are shocked by and surprised by the change," Mabry told Diagnostic Imaging article, calling the MRI joint codes high volume and one of the more common MRI exams conducted by practices. "A 30 percent hit on two fairly commonly performed scans is fairly noticeable."

Mabry also warned that more cuts are coming, particularly with the part of the Taxpayer Relief Act that contains a provision increasing the assumption rate for CT and RMI from 75 percent to 90 percent by 2014.

David Marichal, chief technology officer at Radiology and Imaging Specialists in Florida called the cuts "dramatic." Data from his company's different facilities show that while imaging volume has increased, revenues have decreased.

"It just seems wrong," he told Diagnostic Imaging. "It has definitely affected us."

To learn more:
- read the article in Diagnostic Imaging

Suggested Articles

Payers and providers have made significant investments in digitizing the healthcare system but have yet to see a return on that investment.

Fewer than 4 in 10 health systems can successfully share data with other health systems, which presents a number of challenges.

As telehealth programs continue to expand, it’s crucial to understand how facility management will shift with these advancements in healthcare.