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HCFA moves to pay for nonionics

HCFA moves to pay for nonionics

A proposal to provide differentiated Medicare reimbursement for nonionic radiographic contrast media was embedded in the same 187-page rule containing the relative-value scale regulations (see previous story). Nonionic agents are currently reimbursed at the same rate as less expensive ionic contrast agents.

HCFA proposes to accept the ACR criteria for use of the agents as a policy for payment. Such criteria include history of previous adverse reaction to contrast, a history of asthma or allergy, significant cardiac dysfunction, severe debilitation, and sickle cell disease. The agency is investigating costs for the media to determine an appropriate payment amount.

While HCFA's movement toward payment for nonionic contrast is encouraging, such payment should not be part of a physician reimbursement fee schedule, said Dr. James Moorefield, American College of Radiology chairman.

"This is a drug issue, not a physician services issue," he said. "Payment should not wax and wane as conversion factors wax and wane. And if it's calculated as part of the initial conversion factor, because the payment scheme must be budget neutral, in effect you are not laying out any money to pay for it at all," Moorefield said.


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