Advocacy Alert: Analysis Reveals Proposed Fee Schedule's Potential Impact on SPECT

Nuclear Cardiology Payment Chart Available  
Last week, the Centers for Medicare & Medicaid Services released the CY2023 Medicare Physician Fee Schedule (PFS) proposed rule. The proposed rule includes cuts to the conversion factor that, if finalized, will impact all services in the physician fee schedule. ASNC has analyzed the proposed rule with a focus on the potential impact on nuclear cardiology services.
As in past years, our analysts have compiled a Medicare PFS nuclear cardiology payment chart based on the proposed rule. This valuable benefit of ASNC membership may inform your budgeting and other business planning.

ASNC's nuclear cardiology payment chart is a valuable benefit of membership. DOWNLOAD NOW. If you are not yet a member, JOIN ASNC NOW.

Key Takeaways from Our Analysis

If finalized, the 2023 Medicare conversion factor would be reduced by about 4.5 percent, from $34.6062 to $33.0775. This reduction is largely the result of the expiration of a 3 percent increase to the conversion factor at the end of 2022, as required by law.

The proposed rule also includes changes to the evaluation and management (E/M) code families that were recommended by the CPT Editorial Panel and the Relative Value Update Committee. These changes account for an additional 1.5 percent reduction in the conversion factor due to statutorily required budget-neutrality adjustments. 

According to our analysis, these cuts will result in SPECT suffering a 6 percent cut from July 2022 payment rates. PET and PET/CT services continue to be listed in the proposed rule as carrier priced, which means the regional Medicare Administrative Contractor sets payment rates for those services. 

ASNC Taking Action
These proposed cuts do not account for the realities practices are facing, including increased financial pressures from inflation as well as costs due to the COVID-19 public health emergency. ASNC will continue to advocate to ensure policymakers understand that physicians need predictability in reimbursement rates in order to continue providing optimal patient care to Medicare beneficiaries. 

In the coming weeks, ASNC will urge congressional representatives to stop these significant cuts from taking effect in 2023.

We will keep you informed on our progress.