August 11, 2006
On August 8, 2006, the Centers for Medicare and Medicaid Services (CMS) issued the proposed rule for the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2007. The rule includes proposals to implement two provisions of the Deficit Reduction Act of 2005 (DRA) affecting payment for imaging services under the fee schedule. The first provision addresses payment for certain multiple imaging procedures, with full payment for the first procedure, but a 25 percent reduction in payment for additional imaging procedures furnished on contiguous body parts during the same session. This is a smaller reduction than had previously been proposed. The second limits the payment amount under MPFS to the outpatient department (OPD) payment amount for the technical component (TC) of certain imaging services. Under this provision, the physician fee schedule payment amount for furnishing certain imaging procedures would not exceed the amount paid to a hospital outpatient department. CMS is proposing to apply the multiple imaging reductions first, followed by the OPPS imaging cap, if applicable, which will result in a higher payment than if OPPS imaging cap were applied first.
The SNM prepares charts and spreadsheets that evaluate the impact of the proposed MPFS rule for nuclear medicine procedures and products. Please look for the updated charts early next week (August 14) on the SNM Coding Corner.
The Proposed 2007 MPFS Rule can be found on the CMS website at: http://www.cms.hhs.gov/PhysicianFeeSched/PFSFRN/list.asp#TopOfPage.
The press release issued by CMS on the rule can be found at: http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1939.