Medicare has slashed imaging reimbursements by a third since 2006

It’s not news that Medicare has saved itself a ton of money on spending for medical imaging since the enactment of the Deficit Reduction Act of 2005. But now there are numbers to quantify the hurting the cuts have laid on radiologists and cardiologists—who’ve taken it on the chin even more.

Reviewing Medicare Part B databases spanning 2002 to 2015, David Levin, MD, and colleagues at Thomas Jefferson University in Philadelphia found that, after peaking in 2006, total payments to all physicians for noninvasive diagnostic imaging had dropped 33 percent by 2015.

Payments to radiologists dropped by 19.5 percent by 2015 over that period, while those to cardiologists plummeted by 44.9 percent.

The difference between the two specialties is largely the result of cardiologists’ getting reimbursed mostly on global claims—i.e., both technical and professional components—while radiologists are mostly reimbursed via professional-component claims, which were far less affected, the researchers found.

The study went online April 24 in the Journal of the American College of Radiology.

The team’s key findings include:

  • Total reimbursements to physicians for medical imaging under the Medicare Physician Fee Schedule peaked at a little under $12 billion in 2006.
  • Over the ensuing years, the Deficit Reduction Act and other cuts reduced them by 33 percent, to a whisker over $8 billion, in 2015.
  • Reimbursements to radiologists peaked at $5.3 billion (rounded) in 2006 and dropped to $4.3 billion by 2015 (−19.5 percent).
  • Reimbursements to cardiologists dropped from $3 billion (rounded) in 2006 to $1.7 billion by 2015 (−44.9 percent).

Most other specialties also saw decreases over the study period.

The downtrend in payments “seems to have leveled off in 2014 and 2015,” the authors write in their discussion. “However, with the advent of the Medicare Access and CHIP Reauthorization Act (MACRA) and a new administration, the future of noninvasive diagnostic imaging reimbursements seems uncertain.”