Question:

Do you know how the proposed 2023 Medicare Physician Fee Schedule (PFS) rule conversion factor impacts radiology-related reimbursement?

Answer:

For 2023, CMS is projecting a conversion factor of $33.0775 as opposed to the 2022 conversion factor of $34.6062. The American College of Radiology (ACR) notes that the calculations were made by “first removing the one-year 3 percent increase provided by the Protecting Medicare and American Farmers from Sequester Cuts Act and then applying a negative 1.55 percent budget neutrality update. The budget neutrality update appears to be largely related to increased values for several evaluation and management code families, including hospital, emergency medicine, nursing facility, and home visits.” This seemingly small decrease has a biting impact on radiology reimbursement. CMS projects a decrease of three percent for radiology. For interventional radiology, a sharper aggregate decrease of four percent is expected. Nuclear medicine will see a blow of three percent. Meanwhile, radiation oncology and radiation therapy centers will brace for a one percent decrease. Some circumstances around the decrease remain the adjustments in relative value units (RVUs) along with the second year of the transition to clinical labor pricing updates according to the College’s analysis. Furthermore, the ACR warns that “If Congress does not intervene to extend the three percent increase provided by the Protecting Medicare and American Farmers from Sequester Cuts Act, the percent decreases mentioned above will be greater for CY 2023.”

This question was answered in an edition of our Radiology Compliance Manager. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.

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