Right-sizing cardiac CT reimbursement through local and national efforts: A call to action for the imaging community.

The proposed 2020 CMS Physician Fee Schedule (MFPS) and Hospital Outpatient Prospective Payment System (OPPS) rules issued a reduction in the technical component (TC) payment that would decrease reimbursement for cardiac CT codes by nearly 29% compared to the 2018 final rule. Cardiac CT codes are currently allocated to ambulatory payment classification (APC) 5571, which is used for level I imaging tests with contrast. However, cardiac CT exams utilize more resources and are very different in clinical scope. Current CMS methodology markedly underestimates the actual cost of performing cardiac CT exams. The low reimbursement is a key factor in slowing the adoption of cardiac CT into clinical practice. Grassroot efforts are needed at all institutions who perform cardiac CT, and at local and national levels, to "right-size" reimbursement for cardiac CT exams. This article will provide an overview of various factors affecting cardiac CT reimbursements and advocacy effort.