Radiology practices and imaging centers face many threats for their profitability. Radiology billing has become much more complex, and reimbursements are continuously decreasing. You will find three key challenges you will need to understand and address for the radiology business to thrive in in the future.
The long run is less.
Bundling of services and codes has led to lower (and in some cases considerably lower) reimbursements for providers. Some revised codes carry lower RVUs, reflecting the fact that individuals services were formerly “misvalued” (overpriced).
The Medicare Payment Advisory Committee (MedPAC) lately suggested measures to help reduce imaging reimbursements, including decreasing the threshold for bundling review from 75% to as little as 50%, reducing professional component payments for multiple procedures and studies conducted through the same specialist throughout the same session, and discounting payments for providers who both order and browse images.
Some “thought leaders” (begin to see the Radiology Business Journal June/This summer 2011) believe that professional component reimbursements will probably decrease another 30% within the next 5 years.
Complexity is growing.
Impending new coding procedures will affect both clinical and business operations. New compliance needs will further affect radiology billing procedures. After which there is the move toward more electronic data standards and needs.
With ICD-10, coding is not truly being refined and updated. New codes is going to be longer, there will always be much more of them. RVUs will change, too. Because you will not see much matching between ICD-9 and ICD-10, your employees will need to learn how to precisely “translate” towards the ” new world “.