The Centers for Medicare and Medicaid Services recently released the Medicare Physician Fee Schedule and Hospital Outpatient Perspective Payment System final rules, setting the payment regulations for the office and hospital outpatient settings for 2009.

The rules dictate that the conversion factor for the MPFS will be $36.066 effective Jan. 1, 2009, representing a 5.3 percent decrease from the current 2008 conversion factor of $38.08. According to the American College of Radiology, radiologists will see a 2.7 percent increase next year in their professional component, although the technical component — which is currently not impacted by the third five-year review — will now experience a cut of 5.3 percent.

Also effective Jan. 1 are the new anti-markup regulations, which look to take the profit out of reassignment of benefits for diagnostic tests billed by one entity but services provided by another.

Furthermore, the conversion factor for hospital outpatient payments will be $66.059, a 3.6 percent increase from $63.694 for 2008. For hospitals that do not meet the hospital quality reporting requirements, the reduced conversion factor is $64.784.

Medicare has finalized its proposal to move forward with the five new composite APCs for ultrasound, CT/CTA without contrast, CT/CTA with contrast, MR/MRA without contrast and MR/MRA with contrast. As a result, when more than one US, CT or CTA, MR or MRA study is performed in the same session, the hospital will submit the claim for the multiple studies and Medicare will send back one bundled payment.

The college goes on to say that it is disappointed over CMS’ decision not to implement its proposal to require that all imaging be subject to the Independent Diagnostic Testing Facility quality standards for 2009.

For more information on MPFS specifics, visit the ACR Web site.