Multiple nuclear medicine and cardiology groups are working to oppose potential cuts to myocardial PET scans that were made possible by the CMS 2020 Medicare Physician Fee Schedule (MPFS) proposed rule, according to a joint statement.
The CMS proposed rule included revisions that could lead to technical component payments reductions of up to 80% for services related to myocardial PET scans. A primary “driver” of the cuts is a CMS decision to assume a 90% utilization rate for PET cameras, something that needs to be “reconsidered,” the statement read.
“Pricing information for other equipment also may need to be further refined,” according to the American College of Cardiology (ACC), American College of Nuclear Medicine (ACNM), American Society of Nuclear Cardiology (ASNC), Cardiology Advocacy Alliance (CAA) and Society of Nuclear Medicine and Molecular Imaging (SNMMI), which have all joined together to express concern with the potential cuts.
The issue is important, according to the groups, because payment cuts could result in practice disruptions and may impact patient access to PET imaging.
“The ACC, ACNM, ASNC, CAA and SNMMI are aggressively working to correct the inputs and calculations for the payment formula through the public comment process and communication with policymakers,” the statement read. “If it becomes clear this cannot be accomplished within the constraints of the rulemaking timeline, we will seek alternative approaches, such as a delay period, to allow further analysis and other efforts to continue.”