Aug. 3, 2023 – ADVOCACY ALERT – Analysis: 2024 Proposed Rules Include HOPPS Increases for SPECT and PET, Cut to PET/CT

The ASNC team has analyzed the proposed rules for the 2024 Medicare Physician Fee Schedule (MPFS) and the 2024 Hospital Outpatient Prospective Payment System (HOPPS). ASNC has begun implementing an advocacy strategy for challenging some of the proposals. For details, keep reading. 
Key points from the MPFS proposed rule affecting nuclear cardiology practices: 
  • A phased-in reduction in clinical labor price inputs as well as a statutorily required cut to the conversion factor would result in a proposed fee cut for SPECT services.
  • Under the proposed rule, PET services would remain carrier priced.
Key points from the HOPPS proposed rule affecting nuclear cardiology practices: 
  • The proposed rule includes increased payment rates for both SPECT code 78452 and PET code 78492.
  • CMS has proposed lowering the Ambulatory Payment Classification assignment for PET/CT code 78431. If enacted, this change would result in a double-digit cut for services provided for this code.

As in past years, ASNC has assembled two charts compiling the proposed reimbursement rates for nuclear cardiology services in 2024. These charts are a valuable benefit of ASNC membership. They provide an at-a-glance summary of the codes that matter most to your practice, helping you make informed budgeting and other practice management decisions. ASNC will update these member-only charts when the final rules are released this fall. DOWNLOAD CHARTS.

If you are not yet a member of ASNC and want access to these charts as well as more member benefits, JOIN ASNC NOW.

Next Steps: ASNC's Advocacy Strategy 

ASNC shares your concerns about some of CMS's proposals, including the proposed reduction for PET/CT code 78431. The advocacy team is conducting further analysis on the data that CMS has used to calculate the proposed cut. Once we understand the data, our leaders will be positioned to make the most effective arguments to CMS.

ASNC also will continue pushing Congress to pass HR 2474, the Strengthening Medicare for Patients and Providers Act, a bipartisan effort currently pending in the 118th Congress. Once passed, this legislation would provide annual inflationary updates based on the Medicare Economic Index for Medicare physician services, similar to updates received by other healthcare providers.

Stay tuned to ASNC for updates on these and other advocacy efforts.