Nuclear cardiologists could see significant reductions in Medicare reimbursements in 2025, according to a leading expert.
Despite a proposal by the U.S. Centers for Medicare and Medicaid Services (CMS) to “unbundle” payments for diagnostic radiopharmaceuticals from the cost of nuclear medicine tests, cardiac SPECT procedures may get the short end of the stick, said Lawrence Phillips, MD, of NYU Langone Health in New York City, in an interview with AuntMinnie.com.
“We would see a drop of approximately 3% in the reimbursement per SPECT study performed,” he said.
Among its applications, SPECT is used in 1.3 million coronary artery disease procedures per year. Phillips, current president of the American Society for Nuclear Cardiology (ASNC), said that the organization has not spoken out against the unbundling process. Rather, the CMS should be applauded for the move, given that proponents have been advocating for it since 2008. However, moving forward, the agency needs to be made aware of potential unintended consequences, he said.
Ultimately, there are “many unknowns” to be explored in the next few months – implications regarding the unknown cost of new diagnostic radiopharmaceuticals, for instance – and the ASNC is in continuing talks with the CMS. Nuclear cardiologists need to be aware of the potential negative financial impact and plan accordingly, Phillips said.
