2006 proposed fee schedule - American Society of Clinical Oncology

facility payment rather than a TC claim. Thus, if more
imaging services are performed in physician offices, TC
claims will increase as a share of all fee schedule
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imagining claims. An increase in TC claims occurred between
1999 and 2002, which indicates that imaging procedures
shifted to physician offices. Because the TC of an imaging
service generally is assigned a higher payment rate than the
PC, growth of TC claims as a share of all imaging claims
leads to additional payments under the PFS. These
additional payments accounted for about 20 percent of the
growth in the volume and intensity of imaging services
between 1999 and 2002 (MedPAC 2004).
Recent studies and articles indicate that risk of abuse
for radiology services (and diagnostic nuclear medicine)
will continue if not specifically prohibited. The Journal
of Radiology reported what happened after a managed care
organization halted reimbursement to non-radiologists for
some forms of imaging (other than CT scans, MRIs, sonography
or nuclear medicine) but left the physicians free to refer
their patients to radiologists if they believe the imaging
they had been conducting on their patients was needed. The
following specialties were not allowed to perform any
imaging services: gastroenterologists, general surgeons,
nephrologists, neurosurgeons, oncologists, pediatric
surgeons, and physiatrists. The study found that imaging