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SCCT urges members to take action on the proposed MPFS/OPPS cute to CCTA

On July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) posted the Proposed Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS) Rules for 2020.  These comprehensive rules contain proposed policy and payment changes under the Medicare program.

Under the proposed 2020 OPPS rule, there is a reduction in the technical component (TC) reimbursement amounts for some imaging Ambulatory Payment Classification (APC) groups.   Cardiac CT services are grouped in an APC that would see a reduction in reimbursement.  There are multiple factors that may account for this proposed reduction, including the addition of a new subset of claims that CMS uses to determine rate setting, and the submission of claims that are grossly inaccurate. 

CMS will accept comments on the proposed rules through September 27, 2019.  Submit your comment electronically at http://www.regulations.gov.  Please refer to file code CMS-1715-P1 for the MPFS proposed rule and CMS-1717-P for the Outpatient Prospective Payment System proposed rule.