Researchers at the Department of Imaging Sciences at the University of Rochester Medical Center identified the overall extent of Medicare reimbursement decline in the 50 most common imaging studies in diagnostic radiology. They reviewed global reimbursement data for these 50 services from the Centers for Medicare & Medicaid Services (CMS) for the period from 2011 to 2021. Their findings, released on January 14, 2022, in Current Problems in Diagnostic Radiology, revealed that there was a combined mean reduction of inflation-adjusted payments of 44.4% across these 50 imaging studies in that 10-year time frame.

With the small exception of three out of 50 studies (abdomen, hip, and femur radiographs), the total average adjusted reimbursement overall has significantly declined over that decade. A review of yearly percent change showed only an increase in reimbursement from 2016 to 2017 (+0.2%). The period with the steepest decline was from 2013 to 2014 (-16%). The overall yearly percent change was -5.5%. 

When reimbursement was analyzed by individual imaging modality, the biggest losers were MRI (-60.6%), CT (-44.4%), and ultrasound (-31.3%). Even radiographs did not fare well (-6.2%). An evaluation of work relative value units (wRVUs) during the study period revealed a decline from a mean value of 0.79 to 0.78 wRVUs (-1.3%).

The authors believe the data portrays likely ongoing downward reimbursement trends for radiology services and suggests the need for policymakers to reverse course and create sustainable future reimbursement schedules. I agree.

My take is that while there has also been a considerable increase in the volume of studies performed, forestalling an overall decline in income for radiologists in that same decade, this study reveals a flaw in Medicare payment policy that needs to be addressed. Particularly concerning has been the need for Congressional intervention annually to prevent Medicare payment cuts from being far worse.