Sec. 4002. Medicare payment incentive for the transition from traditional x-ray imaging to digital radiography and other Medicare imaging payment provision
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Section 1848(b) of the Social Security Act ( 42 U.S.C. 1395w–4(b) ) is amended by adding at the end the following new paragraph: In the case of imaging services that are X rays taken using film and that are furnished during 2017 or a subsequent year, the payment amount for the technical component (including the technical component portion of a global fee) of such services that would otherwise be determined under this section (without application of this paragraph and before application of any other adjustment under this section) for such year shall be reduced by 20 percent.
In the case of imaging services that are X rays taken using computed radiography technology— in the case of such services furnished during 2018, 2019, 2020, 2021, or 2022 the payment amount for the technical component (including the technical component portion of a global fee) of such services that would otherwise be determined under this section (without application of this paragraph and before application of any other adjustment under this section) for such year shall be reduced by 7 percent; and in the case of such services furnished during 2023 or a subsequent year, the payment amount for the technical component (including the technical component portion of a global fee) of such services that would otherwise be determined under this section (without application of this paragraph and before application of any other adjustment under this section) for such year shall be reduced by 10 percent.
For purposes of this paragraph, the term computed radiography technology means cassette-based imaging which utilizes an imaging plate to create the image involved. In order to implement this paragraph, the Secretary shall adopt appropriate mechanisms which may include use of modifiers. . Section 1848(c)(2)(B)(v) of the Social Security Act ( 42 U.S.C. 1395w–4(c)(2)(B)(v) ) is amended by adding at the end the following new subclause: Effective for fee schedules established beginning with 2017, reduced expenditures attributable to subparagraph
(A)of subsection (b)(9) and effective for fee schedules established beginning with 2018, reduced expenditures attributable to subparagraph
(B)of such subsection. . Section 1848(b)(4) of the Social Security Act ( 42 U.S.C. 1395w–4(b)(4) ) is amended by adding at the end the following new subparagraph: Not later than January 1, 2016, the Secretary shall not apply a multiple procedure payment reduction policy to the professional component of imaging services furnished in any subsequent year that is prior to a year in which the Secretary conducts and publishes, as part of the Medicare Physician Fee Schedule Proposed Rule for a year, the empirical analysis described in clause (ii). The empirical analysis described in this clause is an analysis of the Resource-Based Relative Value Scale (commonly known as the RBRVS ) Data Manager information that is used to determine what, if any, efficiencies exist within the professional component of imaging services when two or more studies are performed on the same patient on the same day. Such empirical analysis shall include— work sheets and other information detailing which physician work activities performed given the typical vignettes were assigned reduction percentages of 0, 25, 50, 75 and 100 percent; a discussion of the clinical aspects that informed the assignment of the reduction percentages described in subclause (I); an explanation of how the percentage reductions for pre-, intra-, and post-service work were determined and calculated; and a demonstration that the Centers for Medicare & Medicaid Services has consulted with practicing radiologists to gain knowledge of how radiologists interpret studies of multiple body parts on the same individual on the same day. . Section 1833(t)(16) of the Social Security Act ( 42 U.S.C. 1395(t)(16) ) is amended by adding at the end the following new subparagraph: Notwithstanding the previous provisions of this subsection: In the case of imaging services that are X rays taken using film and that are furnished during 2017 or a subsequent year, the payment amount for the technical component (including the technical component portion of a global fee) of such services that would otherwise be determined under this section (without application of this paragraph and before application of any other adjustment under this subsection) for such year shall be reduced by 20 percent. In the case of imaging services that are X rays taken using computed radiography technology (as defined in section 1848(b)(9)(C))— in the case of such services furnished during 2018, 2019, 2020, 2021, or 2022 the payment amount for the technical component (including the technical component portion of a global fee) of such services that would otherwise be determined under this section (without application of this paragraph and before application of any other adjustment under this subsection) for such year shall be reduced by 7 percent; and in the case of such services furnished during 2023 or a subsequent year, the payment amount for the technical component (including the technical component portion of a global fee) of such services that would otherwise be determined under this section (without application of this paragraph and before application of any other adjustment under this subsection) for such year shall be reduced by 10 percent. The reductions made under this paragraph— shall not be considered an adjustment under paragraph (2)(E); and shall not be implemented in a budget neutral manner. .
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- 42 USC 1395w–4(b)
- 42 USC 1395w–4(c)(2)(B)(v)
- 42 USC 1395w–4(b)(4)
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Sec. 4002
Medicare payment incentive for the transition from traditional x-ray imaging to digital radiography and other Medicare imaging payment provision
Cite42 USC 1395w–4(b)
Cite42 USC 1395w–4(c)(2)(B)(v)
Cite42 USC 1395w–4(b)(4)
Cites 4Cited by 0 across 0 sources