Medicare to Pay Less for Higher Dose CT Scans

Radiologist professionals using computed tomography equipment that does not comply with new dose management standards published a year ago will see significant Medicare payment decreases starting in January 2016.

That’s an overlooked provision in Sec. 218 of H.R. 4302, the “doc-fix” legislation President Obama signed recently to put another patch on the Medicare SGR formula for physician payments, and delay the ICD-10 compliance date and auditing enforcement of the hospital two-midnight payment policy.

The language in Sec. 218 seeks to compel radiology departments to upgrade to Standard XR-29-2013 from the National Electrical Manufacturers Association, titled, “Standard Attributes on CT Equipment Related to Dose Optimization and Management.”

The association briefly describes the standard as follows: “Identifies four key features of CT scanners which contribute to or help perform optimization and or management of doses of ionizing radiation while still enabling the system to deliver the diagnostic image quality needed by the physician.” Documentation of the standard attributes, published in March 2013, is available here for $52.

The CT scanner language in the new law calls for a 5 percent cut in Medicare payments for scans taken on equipment not meeting the new standards, with a 15 percent cut for 2017 and subsequent years.

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