Medicare Update: Proposed Change Could Save Recipients Hundreds of Dollars
Summary
The Centers for Medicare & Medicaid Services (CMS) has proposed a rule to reduce costs for Medicare patients by paying the same rate for certain imaging services regardless of where they receive care. This change aims to eliminate higher charges for hospital-owned outpatient facilities compared to doctor’s offices, which could save patients hundreds of dollars in coinsurance costs.Key Facts
- The proposal targets outpatient imaging services like X-rays, CT scans, and MRIs performed at hospital-owned outpatient departments.
- CMS plans to apply "site-neutral" payments, meaning Medicare will pay the same rate whether the service is done in a hospital outpatient facility or a physician’s office.
- This change could reduce Medicare costs by about $260 million and lower patient cost-sharing by roughly $70 million in 2027.
- The new payment rules would not apply to rural Sole Community Hospitals, which are exempt.
- Medicare beneficiaries often pay a percentage of the approved amount (coinsurance), so lower Medicare payments can mean lower bills for patients.
- The policy aims to prevent patients from paying more just because their care happens in a hospital outpatient setting.
- The proposal builds on a previous policy that covered some clinic visits and drug administration services.
- Experts say these changes could help seniors save money, especially those who receive repeated imaging tests.
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