CMS Releases Proposed Rule for 2008
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On July 2, 2007, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2008 Medicare Physician Fee Schedule (MPFS). Of particular interest to ASNC members are the following provisions:
Under Medicare law and the severely flawed sustainable growth rate update formula, physicians are scheduled to (absent congressional intervention) receive a negative 9.9 percent update in their payment rates – reducing the current conversion factor from $37.90 down to $34.15 beginning January 1, 2008.
Because of increases in work RVUs for anesthesia services and additional changes resulting from the Five Year Review of physician work values, CMS proposes to implement a budget neutrality adjustor (0.8816), which would be applied only to the work RVUs for all CPT codes – effectively reducing all work values by 11.8 percent.
There are no proposed changes in the radiopharmaceutical payment methodology in the physician office or IDTF settings for 2008.
Continuation of the Deficit Reduction Act (DRA) payment ceiling on medical imaging technical component services
Finally, CMS has chosen NOT to change the practice expense methodology calculations regarding equipment usage and interest rate assumptions.
Following table summarizes first technical and then professional payment rates for myocardial perfusion imaging (SPECT):
| CPT Code
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Description
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2007 Final MPFS Payment Rate
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2008 Proposed MPFS Payment Rate
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| 78465 (technical)
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MPI SPECT, multiple
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$459.70
DRA $399.44
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$401.89
DRA ?
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| 78465 (professional)
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MPI SPECT, multiple
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$73.14
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$66.58
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| 78478 (technical)
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Wall motion, add-on
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$53.44
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$39.27
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| 78478 (professional)
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Wall motion, add-on
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$26.53
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$23.56
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| 78480 (technical)
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Ejection fraction, add-on
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$53.44
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$39.27
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| 78480 (professional)
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Ejection fraction, add-on
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$18.57
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$15.71
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At web posting, CMS had not yet released the proposed rule regarding the Hospital Outpatient Prospective Payment System, which will include the DRA specific payment ceilings on medical imaging technical component services.
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