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What is the impact of the 2025 MPFS changes on radiology practices?

AuntMinnie

The 2025 conversion factor (CF) that sets the overall rate for the Medicare Physician Fee Schedule (MPFS) was adjusted downward by 2.83% from the 2024 rate, to $32.3465 per RVU vs. $33.2875 per Relative Value Unit (RVU). 879, the Medicare Patient Access and Practice Stabilization Act of 2025, has been introduced but no action has been taken.

Medicare 261
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Higher Medicaid-to-Medicare reimbursement ratios boost imaging use

AuntMinnie

Higher Medicaid-to-Medicare reimbursement ratios (MMRR) are linked to increased likelihood of Medicaid patients receiving CT, MR, ultrasound, and x-ray imaging, researchers have reported. Medicare reimbursement levels are set by individual states, and they vary across the U.S., Nuclear medicine 0.76

Medicare 203
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HPI: Almost a third of image interpretation done by nonradiologists

AuntMinnie

of all imaging studies for Medicare fee-for-service beneficiaries in 2022, but that the remaining 27.9% The team conducted a study that included data from 123 million 2022 Medicare Part B imaging claims. for digital x-ray 0.9% for nuclear medicine 33.9% Nuclear medicine 11.8% X-ray -- -- 97.9%

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HPI: Nonradiologists interpret more than a third of office-based imaging

AuntMinnie

million office-based imaging claims for Medicare fee-for-service beneficiaries in 2022 that were ordered by nonradiologists. They found that rates of self-interpretation varied by imaging modality: Self-interpretation rate for office-based imaging by modality Modality Percentage X-ray and fluoroscopy 50.4%

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How are radiology practices impacted by annual changes to the MPFS?

AuntMinnie

With the passage of the Consolidated Appropriations Act, 2024 (CAA 24) , we finally learned the rates physicians will be paid for Medicare services during the remainder of 2024. This makes the Medicare payment rate 1.77% lower than it was in 2023, rather than the 3.37% cut that was contained in the 2024 MPFS Final Rule. decrease (3.9%

Medicare 279
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Study finds decreases in imaging's share of all healthcare spending

AuntMinnie

Over the years medical imaging has been considered a major contributor to increased healthcare spending, and has been subject to a variety of cost-cutting measures that have been mostly aimed at reducing Medicare and Medicaid costs. Nuclear medicine 40% Use rates by modality, 2010 to 2021 Modality 2010 2021 CT 10.2%

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CT Lung Cancer Screening

Capitol Imaging Services

Some insurance companies, like Medicare, will only cover a CT lung cancer screening if you meet a certain criteria. The test may detect cancer at a later stage than is easily treatable, depending on the speed of the cancer’s progression. The screening may detect benign growths that do not require treatment.