Article Figures & Data
Figures
- FIGURE.
This chart illustrates the criteria for patient inclusion and exclusion.
Tables
- Table 1:
Advanced diagnostic imaging procedures subject to multiple procedure payment reduction performed from January to May 2017
Modality/Imaging Category Count (%) of All Imaging Proportion of Imaging Category Subject to MPPR within Modality Proportion of Imaging Modality Subject to MPPR CT 16,874 (75.9) 61.2% Neuroradiologic 76.4% Musculoskeletal 82.8% Body 52.3% MRI 4780 (21.5) 54.9% Neuroradiologic 55.0% Musculoskeletal 63.8% Body 49.4% Breast 53.3% US 582 (2.6) 85.4% Body 85.4% Total 22,236 (100) 60.5% No. of Procedures Proportion of Procedures Subject to MPPR 75% Reimbursement 95% Reimbursement Presumed 100% Reimbursement $ Increase (%) Prorated Annual Increase $ Deficit (%) Prorated Annual Deficit Imaging categories Neuro-radiologic 9952 67.9% $613,157 $701,503 $723,589 88,346 (14.4) $212,030 22,086 (3.1) 53,006 Body 11,778 53.8% $841,173 $927,297 $948,828 86,123 (10.2) $206,695 21,531 (2.3) 51,674 Musculoskeletal 491 71.7% $31,182 $36,354 $37,648 5172 (16.6) $12,412 1293 (3.4) 3103 Breast 15 53.3% $1142 $1282 $1318 141 (12.3) $338 35 (2.7) 84 Imaging modalities CT 16,874 61.2% $1,058,073 $1,186,614 $1,218,750 128,542 (12.1) $308,500 32,135 (2.6) 77,124 MRI 4780 54.9% $412,381 $460,183 $472,133 47,802 (11.6) $114,724 11,950 (2.5) 28,680 US 582 85.4% $16,200 $19,639 $20,499 3439 (21.2) $8253 860 (4.2) 2064 Total imaging 22,236 60.5% $1,486,654 $1,666,437 $1,711,382 179,782 (12.1) $431,476 44,946 (2.6) 107,870 ↵a Note the new MPPR policy impact on net revenue increase and the current deficit to the full reimbursement.
- Table 3:
Number of patients with multiple advanced diagnostic imagings per day, respective number of imaging procedures, and net revenue loss due to current 5% MPPR
Procedures Count in Single Day No. (%) of Study Patients No. (%) of Study Procedures Net Revenue Loss (%) due to 5% MPPR 2 6226 (70.9) 12,452 (56.0) $20,415 (45.4) 3 1474 (16.8) 4422 (19.9) $9913 (22.1) 4 648 (7.4) 2592 (11.7) $6734 (15.0) ≥5 439 (5.0) 2770 (12.5) $7884 (17.5) Total 8787 (100) 22,236 (100) $44,946 (100) First Image Second Image Third Image Fourth Image Percentage of Study Imaging CT abdomen & pelvis w/contrast CT thorax w/dye 22.9 CT abdomen & pelvis w/o contrast CT thorax w/o dye 6.7 CT neck spine w/o dye CT head/brain w/o dye 4.6 CT angio abdomen & pelvis w/o & w/dye CT angiography chest 2.5 MRI brain stem w/o & w/dye MR angiography head w/o dye 1.7 MRI brain stem w/o & w/dye MRI orbit/face/neck w/o &w/dye 1.5 CT maxillofacial w/o dye CT head/brain w/o dye 1.4 CT neck spine w/o dye CT maxillofacial w/o dye CT head/brain w/o dye 1.2 CT abdomen & pelvis w/o contrast CT thorax w/o dye CT head/brain w/o dye 1.2 CT thorax w/o dye CT head/brain w/o dye 1.2 CT head/brain w/o dye CT head/brain w/o dye 1.1 CT abdomen & pelvis w/contrast CT abdomen & pelvis w/contrast CT thorax w/dye CT thorax w/dye 1.1 CT thorax w/o dye CT maxillofacial w/o dye 0.9 MRI brain stem w/o dye MR angiography head w/o dye 0.8 CT angiography head CT angiography neck 0.8 CT soft-tissue neck w/dye CT thorax w/dye 0.8 CT abdomen & pelvis w/contrast CT thorax w/dye CT head/brain w/o dye 0.8 CT abdomen & pelvis w/contrast CT soft-tissue neck w/dye CT thorax w/dye 0.7 CT abdomen & pelvis w/contrast CT thorax w/dye CT neck spine w/o dye CT head/brain w/o dye 0.7 CT abdomen & pelvis w/contrast CT angiography chest 0.7 MRI brain stem w/o & w/dye MR angiography neck w/o & w/dye MR angiography head w/o dye 0.6 Note:—w/o indicates without; w/o & w/, without and with; w/, with; angio, angiography.
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