Two Scans May Mean Less Reimbursement

Extensive Medicare fee reductions could severely hurt physicians bankbooks in the medical billing arena. Some physicians warn that if the projected 4.3 percent cut takes place in 2006, they may have to go out of business. One of the major issues of the debate deals with radiology scans. The American College of Radiology has a bone to pick with this possible medical billing change.

The 2006 scan rule is as follows: When performing two imaging services on the same day, the payment for the technical component of the second imaging scan will be reduced by 50 percent of the current reimbursement. Radiologists are outraged by this possible medical billing cut. They claim that if credit cards weren’t available or if they couldn’t file late with the IRS, then they would go bankrupt. They claim they are stretched too thin as it is.

The American College of Radiology has brought up some valid complaints with this proposed medical billing cut. They said that there are many times when physicians will perform two imagining scans on the same day, but during completely separate encounters. If the Centers for Medicare & Medicaid Services reduces their reimbursement rate, they will be cutting payments for physicians who have not saved any money on the second scan. This medical billing change could severely hurt the industry and prevent patients from getting necessary second scans.
If possible, for medical billing purposes, try to complete a second scan the next day. If the patient can wait one day for a scan, your medical billing reimbursement will more closely match your cost. Medicare is not designed to offer your practice profit of any kind, but it is also not supposed to cost you money. If this new medical billing bill for radiology takes effect, your practice could potentially lose valuable revenue.

View all Articles by: Melissa Clark, CCS-P