HOPPS Proposal Would Cut CT, MRI Reimbursement

July 11, 2013

CMS’s proposed hospital outpatient payments for 2014 would cut reimbursement for CT and MRI studies by 18 percent to 38 percent, according to the ACR.

CMS’s proposed hospital outpatient payments for 2014 would cut reimbursement for CT and MRI studies by 18 percent to 38 percent, according to an ACR analysis.

Under the proposed rule for 2014 changes to the Medicare’s Hospital Outpatient Prospective Payment System (HOPPS), CMS is proposing to use fiscal year 2011 cost data to establish cost centers for CT and MRI. These would be separate from the diagnostic radiology cost center for determining payments for CT and MRI in the inpatient setting, ACR said. This would result in drastic cuts to outpatient payments, and technical payments would fall below the rates in the Physician Fee Schedule, which would set the in-office imaging rates.

The ACR has been meeting with the federal Office of Management and Budget about this issue, requesting it not be included in the HOPPS rule. “However,” the ACR stated, “CMS has chosen to move forward and propose these changes.”

The proposed rule, released July 8, has a 60-day comment period.