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Outpatient proposed payment rule

This article was originally published in The Gray Sheet

Executive Summary

CMS may bundle hospital payments for multiple imaging procedures performed in one session into a single payment starting in 2009, according to its outpatient payment system 1proposed rule released July 3. The proposal, which would affect magnetic resonance imaging, computed tomography and ultrasound studies, is designed to encouraging imaging efficiencies, CMS says. Multiple imaging procedures are already discounted under the physician fee schedule. The agency also proposes to add four imaging efficiency measures to the existing seven measures hospitals must report to earn a full update in 2009, estimated at 3.2%. Also in the proposed rule, CMS addresses charge compression, a phenomenon that tends to undervalue payments for high-cost technology, but does not propose a short-term fix as industry had hoped. Comments are due Sept. 2, and CMS will release a final rule by Nov. 1, for implementation Jan. 1. Medicare outpatient payments also affect payments for ambulatory surgical centers
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