Paying Accurately For Imaging Services In Medicare

Abstract

This paper describes the rapid growth of imaging services in Medicare and recent changes in how Medicare pays for these services. Certain imaging services may still be overvalued because the Centers for Medicare and Medicaid Services (CMS) uses assumptions for calculating imaging equipment costs that may be inaccurate and uses newer practice-cost data for some, but not all, specialties. In addition, the CMS’s method of adjusting for geographic differences in input prices may overpay for imaging services in high-cost areas and underpay in low-cost areas. We explore issues related to improving the accuracy of imaging payments.