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CMS Initial 2024 Medicare Physician Fee Schedule Includes Cuts for Diagnostic and Interventional Radiology

July 28, 2023

On July 13, 2023, The Centers for Medicare and Medicaid Services (CMS) released its initial 2024 Medicare Physician Fee Schedule (MPFS). The new schedule includes fee cuts for both diagnostic and interventional radiology. According to Becker’s Hospital Review, when adjusted for inflation, Medicare physician payment has effectively declined 26% between 2001 to 2023, before taking into account this latest round of proposed cuts and the last year’s inflationary impact.

More specifically, the preliminary relative value unit (RVUs) changes include:

  • 3% reduction for diagnostic radiology
  • 4% decrease for interventional specialists
  • 3% less for nuclear medicine
  • 2% reduction for radiation oncology

These proposed fee schedule reductions run counter to the payment schedule’s estimate of the current Medicare Economic Index (MEI). This government measure of inflation in medical practice costs stands at 4.5 percent, in addition to last year’s 3.8 percent increase. Along with the fee schedule changes listed above, the proposed 2024 MPFS conversion factor (the dollar amount used to convert RVUs into payment) has also been reduced by more than 3.3% from the current year’s fee schedule. This proposed decrease in the conversion factor causes concern for physicians, including radiologists.

This is clearly disappointing news for radiology and imaging practitioners – as well as hospital radiology departments. An advocacy movement to address these issues by pointing to a critical flaw in CMS’s calculation is underway. Charging the initiative’s momentum: AMA is highlighting CMS’s utilization of 2006 cost information to calculate practice expenses, which ultimately drives decisions on reimbursement. For perspective, inflation between 2006 to 2023 has averaged 51%, a substantive impact on the cost of business. When you account for the 26% decrease in reimbursement over a similar time period, CMS’s referencing such a materially inaccurate cost expectation is dangerous – and certainly not conducive to a stable infrastructure for patient care.

Taking Action

The AMA is currently conducting a survey and gathering data through April 2024. AMA will share an aggregate of this data with CMS to help align a more appropriate calculation of the MEI and Resource-Based Relative Value Scale. You can find a copy of the AMA letter to physician groups – and guidance on how you can help – here.

Moreover, there is a 60-day public comment period on this proposed rule. All interested parties, including providers, are encouraged to submit comments about the proposed changes to CMS to be considered in the final rule’s development. The 60-day comment period closes on September 11, 2023, and you can submit yours at Regulations.gov. CMS asks that any comments related to this rule refer to code CMS-1784-P. For further information about the fee schedule, you can read the press release from CMS or the associated fact sheet.

Further Steps

This recent development heightens the already challenging financial climate radiology practices face. Continued reimbursement compression and pervasive staffing shortages underscore the importance of keeping your cost to collect as low as possible, accelerating payments, and capturing the revenue due. The right RCM service partner can help.

XiFin offers a full range of RCM and billing services that help radiology practices and departments automate their billing workflow, mitigate denials and appeals, glean strategic insights from analytics – and ultimately accelerate cash flow. The backbone of those services is XiFin RPM, our award-winning, SaaS-based solution. Every day, radiology practices, imaging centers, hospitals, and diagnostic providers use XiFin RPM to optimize billing and accounts receivable processes, automate workflow, and reduce regulatory compliance risk – whether they choose to outsource billing work or deploy the solution themselves.

Advocacy Matters

Finally, it’s important that we stand with our customers. Customer and industry advocacy represents a core tenet of our business at XiFin. We actively engage with lawmakers to protect the best interests of our customers and their patients. And delivering innovative, practical solutions requires establishing and maintaining valuable industry affiliations. That helps us, our solutions, and our services stay at the forefront of change – while allowing us to advocate further on our customers’ behalf.


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