CMS updates HOPPS rule due to ACR efforts

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Hospitals will receive as much as a 40 percent increase in interventional radiology payments in an update by the Centers for Medicare & Medicaid Services (CMS) on the Final Rule for the 2008 Hospital Outpatient Prospective Payment System (HOPPS), as a result of the efforts from the American College of Radiology (ACR).

The ACR expressed its concern in comments submitted Jan. 28 on the HOPPS proposed rule that outpatient radiology departments would experience a 25 percent reduction in interventional radiology payments as a result of how cost data was being handled under the new methodology. 

Along with the payment increase, the efforts have resulted in positive implications for other radiology services in the outpatient setting and the ACR said it will continue to work extensively on this issue as it develops to insure that radiology and radiation oncology data is being processed correctly in the new packaging methodology.

The ACR provided a more detailed assessment of the implications of the packaging with specific comments on the ancillary services of concern to the agency and its members regarding the following issues:

  • The complex proposal by CMS to package payment for seven categories of supportive ancillary services. Of the seven, five are of critical importance to radiology: imaging guidance services, image processing services, imaging supervision and interpretation services, diagnostic radiopharmaceuticals and contrast media, and radiation oncology services;
  • Composite ambulatory payment classifications (APCs);
  • Placement of new technologies;
  • Charge compression; and
  • The implications of the final rule with respect to the caps on imaging payments imposed by the Deficit Reduction Act.

The ACR also expressed support for CMS in their decisions to:

  • Continue to pay separately for therapeutic radiopharmaceuticals; and
  • Place cardiac CT and coronary computed tomographic angiography in new APCs with an increase in payment.

Read the ACR comment letter to CMS here.