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National Government Services to evaluate Medicare PET/CT reimbursement

par John R. Fischer, Senior Reporter | May 26, 2021
Business Affairs Cardiology CT Molecular Imaging X-Ray

SNMMI and other groups argued that making cuts like this on such short notice was unsustainable and may lead to practice disruptions that could hinder access to PET services. “One issue relates to CMS using the 90 percent utilization rate rather than the Relative Value Scale Update Committee (RUC)-recommended 50 percent utilization rate for the PET equipment. SNMMI is asking its members to provide updated equipment invoices so that CMS can get the costs of all the equipment correct,” Caitlin Kubler, SNMMI associate director of health policy and regulatory affairs, told HCB News at the time.

The proposal was later delayed before the schedule went into effect in January 2020.

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In a statement, ACR said that current payment rates were inaccurate and needed to be reformed with new and revised codes. “The letter references previous discussions with NGS and contends it should not use ambulatory surgical center rates to pay for physician office service, stating that those rates do not appropriately reflect the cost of performing a service in the office setting.”

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