Radiology Gets a Smaller Slice of the MPFS Pie

Gregory N Nicola, MD, FACR; Lauren P Golding, MD

Appl Radiol. 2021;50(1):28-30.

Abstract and Introduction

Introduction

Payments to radiologists and imaging providers are frequent targets by legislatures and regulators as "pay for" cash pools to divert payments to other health services.^[1–3] That bullseye hasn't seemed to budge, as demonstrated by the 2021 Medicare Physician Fee Schedule (MPFS) proposed rule prescribing an estimated 11% reduction to radiology payments.^[4] The history and mechanics of this payment reduction are worth exploring, as they may serve as a framework for additional payment reductions.

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Table 1. CMS proposal for E&M code restructuring and payment. Proposed Rule MPFS 2019
Level	2018 Payment New Patient	Proposed New Payment New Patient	2018 Payment Established Patient	Proposed New Payment Established Patient
1	$45	$44	$22	$24
2	$76	$44	$45	$24
3	$110	$44	$74	$24
4	$167	$44	$109	$24
5	$211	$135	$148	$93

Table 2. Finalized 2019 Relative Value Units
Level	2019 RVU New Patient	Finalized 2021 RVU New Patient	2019 RVU Established Patient	Finalized RVU Established Patient
1	0.48	0.93	0.18	0.18
2	0.93	0.93	0.48	0.7
3	1.42	1.6	0.97	1.3
4	2.43	2.6	1.5	1.92
5	3.17	3.5	2.11	2.8

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Radiology Gets a Smaller Slice of the MPFS Pie

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Radiology Gets a Smaller Slice of the MPFS Pie

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