CMS Proposes RVU Hikes; Calls for Global Services Cost Survey

The Centers for Medicare & Medicaid Services has proposed to adopt 6-8% increases in the global allowances for most diagnostic imaging services, according to Diane Millman, JD, health care attorney with Washington, DC-based Powers, Pyle, Sutter & Verville, and counsel for the National Coalition for Quality Diagnostic Imaging Services (NCQDIS), which has lobbied for the increase. The proposed increases, which CMS supports in the June 28, 2002, Federal Register, would affect a number of MRI, CT, ultrasound, and other imaging procedures.

Among the proposed RVU changes are increases in: MR Brain Stem without contrast (CPT code 70551) from 13.2 to 14.14; CT Brain with and without contrast (CPT code 70470) from 8.8 to 9.38; U/S; OB/gyn, pelvf complete (CPT code 76805) from 3.48 to 3.65; and Bone imaging, multiple (CPT code 78306) from 5.45 to 5.8.

In the same notice, CMS indicated that it hopes to modify the methodology used to determine allowances for technical (TC) services by subtracting the allowances for professional component services from global allowances. (CMS currently adds professional and TC component allowances to arrive at the global figure.) CMS strongly urged radiology, radiation oncology, and cardiology groups to conduct a multispecialty survey to determine the costs per hour of providing global services.

Table. An estimated 18 million MRI procedures were performed in the United States in 2001, in 5,550 hospital and non-hospital sites. This represents a 51% increase over the 1998 volume of 11.9 million procedures performed in 4,490 sites, as estimated in IMV's previous 1998/99 MRI Census, for an increase of ˜14% per year since 1998.

Also, CMS indicated that the conversion factor will be reduced by 4.4% in Congressional year 2003, in the absence of Congressional action. And unless legislation is passed, the conversion factor will be reduced substantially in subsequent years.

Those interested in writing to CMS in support of the proposed changes are requested to send comments to: Centers for Medicare and Medicaid Services, Department of Health and Human Services, Attention: CMS1204-P, PO Box 8013, Baltimore, MD 21244-8013. Comments are due on August 27.

IMV Census Shows MRI Growth

According to the IMV Medical Information Division's March 2002 Market Summary Report, 18 million MRI procedures were performed in the United States in 2001, representing an annual growth rate of 15% (see Table). The total increased 51% since the survey was last performed in 1998.

IMV surveyed 4,401 sites with fixed MRI systems, and revealed the following data: vascular MRI procedures are performed in 58% of the sites, growing from 1% of 1994 MRI procedures to 4% of 2001 procedures, totaling 830,000 in 2001. Breast and cardiac procedures, which constituted only 1% of procedures each, are conducted by 23% and 13% of the MRI sites, respectively.

"The clinical performance of the 1.5T and higher field magnets continues to drive MRI purchases," reports Mitchell Goldburgh, vice president and general manager of IMV. "Over 60% of the MRI installed base have 1.5T+ magnets, and the reported plans for MRI purchases are consistently for high field systems."

IMV is a marketing research and consulting firm specializing in medical and other advanced health care technology markets. The market summary report compares nationwide trends from the 2001 census with the four prior census surveys that IMV has conducted since 1993.

Industry News

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