Radiology Gets a Smaller Slice of the MPFS Pie

Gregory N Nicola, MD, FACR; Lauren P Golding, MD


Appl Radiol. 2021;50(1):28-30. 

In This Article

Congress Acts

CMS has been unwavering in moving forward with these drastic dollar shifts in the MPFS, despite a multispecialty coalition of opposition and an ongoing pandemic. The ball was placed into the Lame-Duck congress to fix. On Dec.27, 2020, President Trump signed into law the Consolidated Appropriations Act 2021 (Omnibus and Coronavirus Relief Bill) providing $3 billion dollars of additional funding for the MPFS 2021. Additionally, Congress delayed implementation of a controversial add on code. A combination of these actions reduced the financial burden on radiologists from a—10% projected MPFS reduction to a—4% reduction. These measures are temporary, as the new monies will run out at the end of 2021, and the delayed implementation of the add on code is time limited at 3 years. Budget neutrality and a deflating CF will continue to be an issue for radiology, as the process of simplifying and revaluing E&M services is not complete. Inpatient and consultative E&M codes are up next and will also likely be revalued upward with resulting downward pressure on the CF. Likewise, expansion of telemedicine, an innovative way to deliver E&M services via advanced video capabilities, may also strain the fee schedule.

Reducing documentation burden and ensuring more time for physicians to spend interacting with their patients is an overdue improvement in health care. Yet, achieving these goals at the expense of a small number of specialties would be a counterproductive unintended consequence. Radiology groups and departments will suffer budgetary strains, potentially impeding upgrades of aging equipment or investments in new technologies, such as artificial-intelligence applications. Picking winners and losers inside the MPFS permits innovation only in a small portion of the healthcare delivery system, while causing others to suffer. The consequences could be devastating to our profession, and equally injurious to our patients.