CMS Proposes Drastic Cuts to DXA

The Centers for Medicare and Medicaid Services (CMS) have proposed new regulations that will drastically cut payment for dual energy X-ray absorptiometry (DXA; CPT code 76075) and vertebral fracture assessment (VFA; CPT code 76077). [link to CMS-1512-PN Regulation Full Text ]. 

When fully realized in 2010, this would amount to a decline in payment of 71% for DXA and 37% for VFA.

ISCD is concerned that this will markedly reduce the availability of high quality bone mass measurement and thus have a profound adverse impact on patient access to appropriate skeletal health care.  Such an outcome is directly contrary to multiple initiatives at the Federal level including the Bone Mass Measurement Act, the US Preventive Services Task Force recommendations and the Surgeon General’s Report on Osteoporosis, all of which underscore the importance of osteoporosis recognition using DXA and the value of appropriate prevention and treatment approaches to reduce the personal and societal cost of this disease.  Moreover, in contrast to other imaging procedures where costs are escalating but improvements in patient outcome have not been clearly demonstrated, DXA and VFA are of relatively low cost and of proven benefit.  Additionally, DXA and VFA are readily available to patients being seen by primary care physicians and specialists alike.

On Friday, August 18 the ISCD filed our written comments to CMS Administrator Dr. Mark McClellan.  Click the link above to read our full response to the CMS proposed reduction in DXA and VFA reimbursement.  We requested that CMS review the proposed cuts, and, at the very least, keep reimbursement at current levels.

An important aspect of our argument consisted of results from the RUC survey in which many of you participated.  This survey revealed that clinicians spend substantially greater time and effort in DXA interpretation than previously appreciated by CMS.  Though the timeline was very tight, 453 physicians (84% of them ISCD members) completed this survey.  This high participation speaks highly of the dedication that you have to the field of bone densitometry and osteoporosis care.  

The survey results continue to be analyzed.  We will report on the results in future editions of our SCAN® newsletter and the Journal of Clinical Densitometry (JCD). 

CALL TO ACTION

ISCD members must make a concerted effort to ensure this regulation is not adopted.  You can help by doing the following:

Congress is listening!  Thanks to your terrific responses – immediate and heartfelt -- our elected officials in Congress are beginning to understand how CMS’s proposed drastic Medicare cuts will hurt patients and undermine federal goals to prevent osteoporosis.  Our targeted efforts to members who live and practice in the home districts of key Senators and Representatives were especially beneficial.  We still have a long way to go in reversing these cuts, but our voices are being heard.  Thanks to everyone who is taking the time to write and call their Legislators.  This type of coordinated campaign is very effective in delivering our message to decision-makers. 

Recent Developments

Senator Barbara A. Mikulski (D-Maryland) has drafted a letter to CMS administrator Dr. Mark B. McClellan urging him to withdraw the substantial cuts in proposed rules that reduce Medicare reimbursement for technologies used to screen for osteoporosis (CMS-1512-PN) and breast cancer.   The Senator is circulating a letter to her Senate colleagues asking them to sign on to the letter to Dr. McClellan.   ISCD, as a leading authority on the diagnosis of osteoporosis, is prominently cited in both letters.  Following are links to the letters:  

Senator Mikulski notes “…These cuts in basic preventative services are directly at odds with public health messages encouraging women to get screened, as well as Dr. McClellan’s commitment to disease prevention, and the “Welcome to Medicare” physical exam, which he instituted.”

Archive Links and Documents

Following are links to relevant documents regarding this crucial issue.  See how the ISCD is working on your behalf and how you can help in our efforts.

Legislative Alerts

Click here for details and how you can help.

Public Policy Issues page

Page Last Updated: 12/11/2010

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