CMS Reimbursement Reduction for CR Technology in 2018

CMS Reimbursement Reduction for CR Technology in 2018

December 1, 2017

My physician read that we will be paid less for radiology services in 2018, and that we need to use a special modifier because we use CR technology.  Do you know anything about this?

Yes, that is correct.  Medicare will institute a 7 percent reduction in reimbursement for the technical component (TC) of x-rays taken using computed radiology (CR) beginning January 1, 2018. This reduction will be in place till 2022, and then increase to a 10 percent reduction. Computed radiography technology is defined as “cassette-based imaging that utilizes an imaging plate to create the image involved.”

For reporting, CMS created modifier ‘‘FY’’ (X- ray taken using computed radiography technology/cassette-based imaging), which should be appended to the X-ray service reported either globally (without any modifiers) e.g.  73502-FY, or the x-ray code with the TC modifier appended, indicating only the technical component is being reported for reimbursement e.g. 73502-TC,FY.

The technical component of musculoskeletal X-ray codes ranges from 63% to 78% of the global value, so the practice should expect reimbursement from 94.5% to 95.6% of the standard allowable.

(100% x 37%  for professional portion) + (93% x 63% for technical portion) = 95.6%

(100% x 22%  for professional portion) + (93% x 78% for technical portion) = 94.5%

*This response is based on the best information available as of 12/01/17.



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