How Radiology Maintains Relative Value Units But Could Lose Big in Reimbursement: The Power of the Conversion Factor

Radiology in the News: A Content Analysis of Radiology-Related Information Retrieved From Google Alerts

“… 27 , 28 , 29 , 30 For example, the 2019 Medicare Physician Fee Schedule proposed by the Centers for Medicare and Medicaid Services has been a topic of much discussion within the radiology community in recent months. 31 , 32 To our surprise, however, we found that only 7% ( n = 10) of all links discussed the topic of radiology reimbursements, which is popular in peer-reviewed literature. 31 , 33 Rather, links related to market trends most frequently discussed recent and future market growth trends in the areas of information technology, interventional radiology, and radiology equipment.…”

“… 31 , 32 To our surprise, however, we found that only 7% ( n = 10) of all links discussed the topic of radiology reimbursements, which is popular in peer-reviewed literature. 31 , 33 Rather, links related to market trends most frequently discussed recent and future market growth trends in the areas of information technology, interventional radiology, and radiology equipment.…”

The impending conversion factor crisis and neurointerventional practice

“…Furthermore, Medicare has decreased physicians' payments by almost 25% just between 2001 and 2018 relative to inflation. 10 The proposed CF 10.61% decrease in 2021 to $32.26 is an unprecedented reduction, bringing the CF close to 1992 when it was $31.00. Adjusted for inflation, the 2021 proposed amount would be even lower.…”

Evaluation and Management Coding Initiative

“…Under these budget neutrality rules, whenever increases are realized in one family of codes, the cost needs to be recovered from elsewhere. In the 2021 MPFS proposed rule, the conversion factor that applies to all codes was adjusted downward such that the net result of all costs for physician services is neutral [ 3 ]. Bottom line, along with other adjustments, radiologists are scheduled to lose 11% reimbursement on an average annualized basis for Medicare services, and some specialties who are heavy billers of E&M services will see increases in their reimbursement up to 17%.…”