Medicare Payment Increase in Final Budget Reconciliation Bill
The bill includes a 2.5% increase to the Medicare Physician Fee Schedule for calendar year 2026.
Read moreThe American College of Radiology® (ACR®) expressed concern about the decision by the Centers for Medicare and Medicaid Services (CMS) to retroactively remove CPT® codes 0554T-0558T (biomechanical computed tomography (BCT) analysis) from the National Coverage Decision (NCD) 150.3 Bone Density Studies. These CPT codes describe services used for determining bone density using the FDA-cleared bone densitometer.
In its latest policy guidance, CMS non-covers biomechanical computed tomography (BCT) analysis retroactive to July 2019. The College seeks guidance from CMS on how healthcare providers should handle claims using these codes going forward. We believe that claims paid using these codes should not be adjusted unless there is concern that these services were not properly furnished.
The ACR and other specialty societies continue to engage with CMS to improve public notice and comment opportunities for coverage and policy articles. The change in coverage status for CPT codes 0554T-0558T retrospective to July 2019 proves existing processes are not adequate.
For questions on Medicare Coverage processes, contact Alicia Blakey, ACR Principal Economic Policy Analyst.
Medicare Payment Increase in Final Budget Reconciliation Bill
The bill includes a 2.5% increase to the Medicare Physician Fee Schedule for calendar year 2026.
Read moreCMS Announces Prior Authorization Test Model
WiSer is a six-year program that will begin in six states on January 1, 2026. It will introduce prior authorization using AI technology for a select number of services, including some IR procedures.
Read moreSupreme Court Upholds Preventive Services Coverage
ACR commends the Supreme Court’s ruling affirming the constitutionality of the structure and appointment process of the U.S. Preventive Services Task Force.
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