CMS wants payment cuts, extends self-referral ban

September 1, 2005

Opponents of the government's plans to reduce technical payments for cross-sectional imaging of contiguous body parts and to apply the self-referral laws to nuclear medicine have until the end of this month to voice their disapproval.

Opponents of the government's plans to reduce technical payments for cross-sectional imaging of contiguous body parts and to apply the self-referral laws to nuclear medicine have until the end of this month to voice their disapproval.

The Centers for Medicare and Medicaid Services has identified 11 families of imaging procedures by imaging modality and by contiguous body area that will be affected by the change. When contiguous body parts are imaged in a single session, CMS proposes to pay 100% for the first procedure and 50% for all others.

Medicare proposes including diagnostic and therapeutic nuclear medicine under the federal referral laws known as Stark II. This would prohibit nuclear medicine physicians from referring patients for imaging to facilities where the referring physicians have a financial interest.

The plan does not apply to the in-office exemption that allows cardiologists to provide nuclear cardiac imaging in their offices, according to CMS officials.

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