Practice Management

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  • 1.  AI- CMS expense allocation

    Posted 03-21-2019 14:24
    Hello,
    Does anyone know how CMS is allocating the expense of AI?

    Thank you

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    Chris Snyder
    Chief Operating Officer
    Radiologic Associates of Fredericksburg
    Fredericksburg VA
    (540) 361-1000
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  • 2.  RE: AI- CMS expense allocation

    Posted 03-21-2019 15:12
    They are not at this time.  They have rolled CAD into reimbursements but AI gas not yet been addressed to my knowledge....



    Sent from my Verizon, Samsung Galaxy smartphone





  • 3.  RE: AI- CMS expense allocation

    Posted 03-21-2019 15:22
    I doubt that AI has shown up in CMS cost data used for the MPFS in any meaningful way as of now.

    I can see two possible scenarios in the future.

    If AI technology becomes associated with a specific code, then the cost of the software and related hardware might become a direct practice expense input for the RVU's for that code based on survey data.  CAD was a good example of this.

    Otherwise, as long as AI is considered optional and not standard of care, I think you're looking at AI being considered as an indirect overhead expense, like a RIS system, to the extent it's adopted by the practices who provide practice expense cost data.  We're probably a long way from having that sort of expense reflected in the MPFS in a significant way.

    The answer might be different on the hospital side...

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    David Smith FACMPE
    Executive Director
    United Imaging Consultants
    Mission KS
    (785) 393-8387
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  • 4.  RE: AI- CMS expense allocation

    Posted 03-21-2019 15:27

    Two things to also keep in mind:

    1.      Unless there is direct involvement by the radiologist, AI/CAD processing cannot usually be billed (ACR has good guidance on this); and

    2.      Any AI that makes us more time-efficient may affect the practice expense calculations CMS does to determine reimbursement, possibly lowering reimbursement, despite the additional cost of the AI.

    With the government, its always best to be careful what you ask/wish for...

    Liz