Significant Legislation for Imaging Procedures Signed Into Law
The Deficit Reduction Act (DRA) of 2005 was signed into law on February
9, 2006 by President Bush. This comprehensive legislation provides that
payment rates for imaging services delivered in physicians' offices and
freestanding facilities may not exceed payment rates for identical imaging
delivered in hospital outpatient
departments,
effective
for services furnished on or after January 1, 2007. The reduction will
impact the payment for x-ray, CT, MRI, ultrasound, fluoroscopy and Nuclear
Medicine imaging procedures. The DRA also provided for a zero percent
reduction for services performed under the Medicare Physician Fee Schedule
(MPFS), as opposed to the 4.4 percent reduction as was previously adopted
per the final 2006 regulation for MPFS. This change is effective for
all services on or after January 1, 2006. All claims that were processed
with the 4.4 percent reduction can now be reprocessed with the new adjusted
rate. Providers can file a claim requesting a redetermination of payment
using the necessary form. Medicare contractors will make the necessary
adjustments no later than July 1, 2006. The redetermination form must
indicate the new billed amount for each code and can be accessed from
the Centers for Medicare and Medicaid Services web site at:
http://www.cms.hhs.gov/MedlearnMattersArticles/ downloads/mm4313.pdf
Interested parties wishing to contact either US Congressional members
or Professional Societies about the reductions for 2007 can view contact
information on the following web site: http://www.gehealthcare.com/usen/community/
reimbursement/docs/proff_soc.pdf
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Spring 2006
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