July 2, 2009 - In the Centers for Medicare and Medicaid Services' (CMS) review copy of the 2010 Medicare Physician Fee Schedule (MFS) proposed rule on July 1, 2009, it would change equipment utilization rate from current 50 percent to 90 percent for equipment priced over $1 million. This would cut the technical component of CT, MR and IMRT by as much as 40 percent for 2010. released the
The American College of Radiology (ACR) will be submitting comments to CMS addressing issues of concern by the deadline of August 31, 2009.
The following items are the highlights of the proposed rule:
(1) Effective January 1, 2010, the conversion factor for the MPFS will be $28.3208. This is a 21.5 percent decrease from the current 2009 conversion factor of $36.066. Medicare must run the SGR formula and implement this cut unless Congress overrides this mandate.
(2) CMS proposes to remove drugs from the calculation of allowed and actual expenditures used in the SGR formula.
(3) The impact is -11 percent for radiology, -19 percent for radiation oncology, -10 percent for interventional radiology, and -13 percent for nuclear medicine as a result of changes to the practice expense and malpractice values.
(4) CMS will publish a notice to solicit applications from entities for the purposes of becoming a designated accreditation organization by November 1, 2010. The mandatory program for CT, MR and nuclear medicine (including PET) is mandated to be implemented by January 1, 2012.
(5) CMS proposes to update the practice expense data to be used in calculation practice expense values in the physician fee schedule. For 2010, CMS proposes to include new practice expense per hour data from the Physician Practice Information Survey conducted by the AMA.
(6) CMS proposes to change the equipment utilization rate from current 50 percent to 90 percent for equipment priced over $1 million. This would cut the technical component of CT, MR and IMRT by as much as 40 percent for 2010.
(7) CMS proposes not to make any changes to their payment localities. However, the 1.00 work GPCI floor will be removed as of January 1, 2010 as required by MIPPA. As a result, 54 out of 89 physician fee schedule localities will receive a decrease in their work geographic practice cost index.
(8) CMS provides a clarification on one aspect of the physician stand in the shoes provision.
(9) Quality and patient outcome provisions through revisions to PQRI and Electronic
(10) Prescribing Incentive Program. Providers that meet the requirements of each program in CY 2010 will be eligible for incentive payments for each program equal to 2 percent of their total estimated allowed charges for the reporting periods.
(11) CMS is interested in obtaining information on the role of radiology assistants (RA) and radiology practitioner assistants (RPA), including the level of physician supervision that would be appropriate when RAs and RPAs are involved in the performance of the technical component of advanced medical imaging.
The ACR is currently reviewing the 2010 MFS proposed rule and will submit comments to CMS.
For more information: www.acr.org