MR reimbursement decline surpasses all other imaging modalities

por John R. Fischer, Senior Reporter | July 29, 2020
The greatest mean decrease in annual change for MR was $52.08.
Medicare reimbursement for MR scans dropped $52.08 between 2007 and 2019, the most of any imaging modality, according to a study conducted at Brown University.

The researchers attributed declines among imaging modalities as likely due to the enactment of policies meant to reduce Medicare spending.

“After accounting for inflation, reimbursement rates were shown to decline for all studies across all imaging modalities except for individual studies in nuclear medicine, radiography, and ultrasound,” the authors wrote.
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The researchers included common diagnostic radiologic studies across multiple imaging modalities in their analysis, including bone densitometry, CT angiography, CT, mammography, MR angiography, MR, nuclear medicine, radiography and ultrasound. Reimbursement data was collected by querying the Physician Fee Schedule Look-Up Tool for Current Procedural Terminology codes, and all monetary data was adjusted for inflation to 2019 U.S. dollars.

Calculating annual growth rate, average annual change and total percentage, the researchers found that decreases for the latter two across all imaging modalities over the 12-year period. Inflation-adjusted reimbursement rates decreased, on average, for about 92% of studies.

Bone densitometry, meanwhile, saw the largest decrease in total percentage change at -70.5%, while nuclear medicine had the smallest mean decreases in both annual change ($0.32) and total percentage change (-4.28%). MR had a -64% drop in total percentage change, followed by MRA (-54%); CTA (-52.5%); and CT (-45%). Nuclear medicine, however, saw hepatobiliary iminodiacetic acid scans with cholecystokinin increase at 67% or $17.15.

The authors attributed the decreases to the Medicare sustainable growth rate enacted under the Balanced Budget Act of 1997. The policy cost doctors and hospitals $116.4 billion in payments until it was repealed in 2015.

The team asserts that further research is required to determine if this trend will continue in the future, but that the changes are likely to benefit patients. “Although studies in diagnostic radiology are experiencing decreased reimbursement rates, this is translating into lower cost-sharing responsibilities for patients, making these studies more affordable and accessible for individual patients.”

The findings were published in the Journal of the American College of Radiology.

The researchers did not respond for comment.

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