Radiology Reimbursement Hit by 2022 MPFS Changes

Radiology reimbursement will be hit by two proposed changes in the 2022 Medicare Physician Fee Schedule:

  • Wages for clinical labor staff would be increased, a move that is projected to directly impact reimbursement rates for radiologists and other specialties.
  • The Merit-based Incentive Payment System (MIPS) would remove two radiology measures and quality bonus points. 

These impacts are in addition to conversion factor and other proposed changes that will reduce 2022 radiology reimbursement. See 2022 Radiology Reimbursement: Good News and Bad News for those details. 

Regarding the wages for clinical labor staff:

“…these practice expense components are subject to budget neutrality, meaning increased spending in one place requires cuts elsewhere. As such, interventional radiology, radiation oncology and other specialties with high medical supply costs and lower spending on clinical labor positions could face significant reimbursement reductions next year, experts predict.”

To combat this, the Society of Interventional Radiology (SIR) is partnering with the American College of Radiology (ACR), the American Medical Association, and the CardioVascular Coalition to “pursue all regulatory and legislative options to protect radiology practices.” 

“CMS estimates cuts attributed to periodic labor pricing updates would land at 5% in interventional radiology and 1% for radiology. That’s in addition to a 9% cut for IR and 2% in radiology because of adjustments in the conversion factor used to calculate reimbursement, mandated sequestration and cuts to practice expense values. SIR said the proposed reductions represent a ‘perfect storm,’ resulting from the feds’ failure to keep labor rates current with inflation. 

For the 2022 MIPS program, CMS proposes to retire MIPS measure 195, covering stenosis measurement in carotid imaging reports and 225, related to reminder systems for screening mammography. In an Aug. 18 update, the American College of Radiology (ACR) said, “The pool of measures available to radiologists has been significantly reduced over the last few years of the MIPS program and the ACR intends to push back against the removal of additional radiology measures.”

Even worse, according to the ACR, is another proposal to remove quality bonus points for additional high-priority measures. And the CMS proposal to raise the data completeness threshold for quality measures up to 80% has been criticized. 

Resources: 

https://www.radiologybusiness.com/topics/policy/radiology-merit-based-incentive-payment-system

https://www.radiologybusiness.com/topics/economics/radiologist-reimbursement-cms-clinical-labor-wage

 

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