We previously alerted you to a CMS-proposed change that would cut reimbursement for the complete diagnostic musculoskeletal ultrasound (MSUS) significantly. We are pleased to report that, in its final rule, the CMS reversed that decision, and providers will see a reasonable reimbursement for the exam.
The ACR advocated on your behalf for this change through the comment period and urged the CMS to reconsider its decision on the drastic cut to this important procedure in rheumatologic care. We believe the magnitude of the proposed reduction for CPT code 76881 would have potentially reduced patient access to this diagnostic test and simultaneously increased the use of more expensive advanced imaging, such as magnetic resonance imaging. Unintended consequences, such as biasing the venue of care toward hospital-based imaging centers, could also have occurred. We were also concerned about the impact these cuts would have on the training of fellows in the use of MSUS.
The ACR is pleased that the CMS has maintained an appropriate value for CPT code 76881. Ensuring adequate reimbursement levels for musculoskeletal services on behalf of our members ultimately helps provide patients access to this important technology.
For questions on the CMS final rule and regulatory program, contact Kayla Amodeo, PhD, at [email protected]. For questions on RVUs, coding and reimbursement, contact Antanya Chung at [email protected].
