It’s strange but true: Medicare has put a different value on your body parts.

The medical imaging industry is reeling from a blow by Congress to reduce Medicare reimbursement for imaging tests of contiguous body parts, such as a CT scan of the abdomen and pelvis, when the diagnostic procedures are performed at outpatient imaging centers and doctors’ offices.

Congress delivered a second strike with its Deficit Reduction Act of 2005 by reducing Medicare payment to physicians and the imaging centers for the scans, to be on par with what hospitals get paid.

From the government’s perspective, these measures are necessary to curtail huge spikes in Medicare spending for imaging tests performed in outpatient settings. The proliferation of such centers and stepped-up use of high-tech imaging tests caused a 20 percent spending increase in 2004, according to one estimate from the Centers for Medicare and Medicaid.

Radiologists and imaging center managers counter that the long-term consequence, if the government doesn’t backtrack from these decisions, will be belt-tightening on their part that will include holding off on spending big money for the latest scanners.

In addition, patients might experience longer waits for appointments as more baby boomers age and need these diagnostic tests.

“It affects places like here,” said Mike Conrath, chief executive officer of Naples Diagnostic Imaging Centers, or NDIC, recognizing the bulk of imaging tests are performed on older patients on Medicare. “Unless (the cuts) get overturned, which is always possible, it would be a huge effect.”

Moreover, private insurers adjust their reimbursement rates to reflect what Medicare does, he said. If the changes in Medicare reimbursement hold, then private insurers will follow suit and reduce reimbursement for imaging scans.

Under the new reimbursement system that kicks in this year, CMS will continue to cover an initial imaging test, such as a CT or MRI, but is reducing reimbursement by 25 percent when a contiguous body part is scanned after the first procedure. Next year, the payment cut increases to 50 percent for the second or even third body-part scan.

One way imaging centers could work around the cut is to have patients come in for separate appointments for each scan but that’s a great inconvenience and centers likely won’t take that course, said Brad Reid, administrator of Radiology Regional Center, a group practice of 27 radiologists in eight imaging centers from Cape Coral to Naples.

“I would certainly hope people won’t (do that) because of the big computer in the sky,” he said, referring to CMS auditors. “(The centers) would get a knock on the door.”

Some imaging center administrators and industry representatives say they were blindsided by lawmakers’ decision to cut multiple scan reimbursement. Mammograms are excluded.

“We absolutely didn’t know it was coming,” Conrath, of NDIC, said.

Reid said his group was aware of the plan to reduce physician reimbursement, but the multiple-scan reimbursement cut “did come absolutely as a surprise.”

The Congressional Budget Office estimates the federal government will save $2.8 billion over five years on the reduced payment for multiple body-part scans.

The American College of Radiology, on the other hand, estimates that is greatly underestimated and the impact would be more in the neighborhood of $6 billion over 5 years.

“It’s draconian,” said Dr. Mark Marzano, medical director of American Radiology Services in Collier County. “I don’t think anyone predicted how drastic it would be.”

Marzano said the community is blessed with good imaging centers with NDIC, Radiology Regional and his group, and everyone will have to increase their volume to compensate for the reimbursement losses.

He also expects imaging equipment vendors will offer discounts on the costs of the machines, which can run $1 million or more.

Radiology Regional is expecting a 3 percent revenue reduction from the combined cuts, Reid said. That’s on top of increasing costs of doing business and increased medical malpractice insurance.

Still, Reid said patients won’t immediately see any differences because the covered services under Medicare aren’t changing.

“Patients won’t see any decline in services; that’s certainly not our plan,” he said.

But in the long run, patients will wait longer for appointments because some imaging centers might close and others won’t make the investment in the latest scanning equipment.

“We’re certainly tightening our belts and looking at every facet of our expenses,” Reid said.

Anchor Health Centers, which has several imaging centers in Collier, estimates a 1 percent loss in Medicare reimbursement, said Gail Murphy, with Anchor’s billing department.

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