SNMMI Comments on 2020 Proposed Medicare Physician Fee Schedule

September 9, 2019

SNMMI and the American College of Nuclear Medicine recently responded to the Centers for Medicare and Medicaid Services' 2020 Proposed Physician Fee Schedule. The full letter can be found here.

In brief, the organizations highlighted: 

  • Proposed Valuation of Specific Codes for CY 2020
  • Evaluation and Management (E/M) Office Visit Services
  • Appropriate Use Criteria 

As previously reported, the society is working with other organizations to address the payment inputs for myocardial PET. The new changes potentially lead to technical component payment reductions as high as 80 percent for some services.  These revisions result from updates to the current procedural terminology (CPT) codes used to report these services and review of the direct practice expense inputs that inform the calculation for the technical component payment.

One driver of the cuts is a decision by CMS to assume a 90 percent utilization rate for PET cameras, an assumption that needs to be reconsidered. Pricing information for other equipment also may need to be further refined. The American College of Cardiology (ACC), American College of Nuclear Medicine (ACNM), the American Society of Nuclear Cardiology (ASNC), Cardiology Advocacy Alliance (CAA) and SNMMI are actively working together on your behalf to address this significant issue.

Learn more about these comments and how you can get involved here