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Reimbursement In Brief

This article was originally published in The Gray Sheet

Executive Summary

Once, twice, three times an image: CMS will not reduce its payment for multiple single-session imaging procedures performed on adjacent body parts in hospital outpatient settings, the agency notes in the 2007 outpatient payment proposed rule, slated for the Aug. 23 Federal Register. In last year's rule, CMS rescinded an earlier proposal to impose a 50% reduction on the priciest procedure of multiple images taken during one visit, but suggested it would reconsider the provision for 2007. CMS is tentatively convinced that the appropriate efficiencies of not having to duplicate certain costs for single-session procedures are already reflected in current payments, but will continue to study the issue. Sessions of multiple myocardial positron emission tomography scans would experience substantial payment reductions under a separate proposal. Meanwhile, physicians likely will remain subject to their current 25% reduction in payments for multiple imaging procedures (1"The Gray Sheet" Nov. 14, 2005, p. 9)...

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