December 1, 2017
My physician read that we will be paid less for radiology services in 2018, and that we need to use a special modifier because we use CR technology. Do you know anything about this?
Yes, that is correct. Medicare will institute a 7 percent reduction in reimbursement for the technical component (TC) of x-rays taken using computed radiology (CR) beginning January 1, 2018. This reduction will be in place till 2022, and then increase to a 10 percent reduction. Computed radiography technology is defined as “cassette-based imaging that utilizes an imaging plate to create the image involved.”
For reporting, CMS created modifier ‘‘FY’’ (X- ray taken using computed radiography technology/cassette-based imaging), which should be appended to the X-ray service reported either globally (without any modifiers) e.g. 73502-FY, or the x-ray code with the TC modifier appended, indicating only the technical component is being reported for reimbursement e.g. 73502-TC,FY.
The technical component of musculoskeletal X-ray codes ranges from 63% to 78% of the global value, so the practice should expect reimbursement from 94.5% to 95.6% of the standard allowable.
(100% x 37% for professional portion) + (93% x 63% for technical portion) = 95.6%
(100% x 22% for professional portion) + (93% x 78% for technical portion) = 94.5%
*This response is based on the best information available as of 12/01/17.