Dermatologists, hematologists/oncologists, interventional pain management practitioners, neurologists, otolaryngologists, radiologists, urologists, and vascular surgeons would receive an average 1% to 2% cut in pay.
For some specialty organizations, these changes will not sit well, and specialty societies are already parsing the rules to find ways they can fight back.
This particular set of proposed changes is "particularly complicated," with some parts of it having a potentially "Draconian impact," said Michael Steinberg, MD, chairman of the board of directors of ASTRO, the American Society for Radiation Oncology. "We did not expect some of the things" that are being proposed.
"We're still analyzing this, but it appears that some of the codes have been cut by as much as 40%, for example, 77301 for IMRT, (intensity modulated radiation therapy) planning. We believe there's a substantial impact there."
ASTRO plans to survey its members as it understands the proposed rules better, especially the impact these new payment policies could have on "small rural centers – and whether it will create access problems" for Medicare beneficiaries when fewer of such facilities are around or offer fewer services.
Geraldine McGinty, MD, chairwoman of the American College of Radiology's economics commission, says that the proposed cuts come after "a cascading series of cuts" in recent years. "And there are a lot of implications; practices are struggling to survive, these are small businesses that provide care, and jobs, and physicians say that with these cuts it's more difficult to buy more equipment, and that has a (negative) impact on innovation.