November 2007

CMS finalizes x-ray reimbursement rule

The Centers for Medicare and Medicaid Services (CMS) has finalized a proposed rule that will eliminate patient reimbursement for x-rays referred by a doctor of chiropractic and ordered by a radiologist or other nontreating physician. The American Chiropractic Association (ACA) opposed the rule.

In a news release, the ACA said it “has vowed to continue to fight the new policy, which is scheduled to go into effect Jan. 1, 2008”.

The new rule reverses a long-standing policy originally obtained by ACA and specifically eliminates Medicare patient reimbursement in connection with the referral of a beneficiary by a doctor of chiropractic to a radiologist or other non-treating physician for x-rays; however, DCs will still be able to refer patients to any treating physician, such as a primary care provider, for needed x-rays.

In August, ACA submitted comments to CMS regarding this rule, specifically noting concerns that the then-proposed change could hamper the chiropractic profession’s ability to refer patients directly to a radiologist, placing particular emphasis on the fact that patients may be required to make additional and unnecessary visits to their primary care providers, which would drive up the costs of patient care. ACA also orchestrated a grassroots campaign when the proposal was first made public in July. The campaign urged the profession, as well as Medicare patients, to contact CMS and insist the agency shelve the x-ray proposal. 

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