SIR and its members are dedicated to improving public health through pioneering advances in minimally invasive, image-guided therapies.
Regulatory comment letters
The Centers for Medicare and Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS addresses Medicare rates and policies under Part B, as well as the Quality Payment Program (QPP) value-based payment programs: Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
The final rule was published on Nov. 15, 2019, and posted here.
SIR often submits comment letters to federal agencies, CMS, and insurance carriers that specifically address interventional radiology treatments. The following comment letters are available:
The SIR coding and reimbursement subcommittee sent several carrier-advocacy letters on behalf of our membership to advocate for appropriate reimbursement of specific IR procedures properly. To learn more, view and, download these resources, please go to the SIR comment letter archive’s page.
Coverage letter templates
SIR has found that sometimes carriers deny reimbursement to the physician or the patient for specific interventional radiology treatments. The society has developed several examples of common coverage request letters.
Improper specialty designator for IR could impact future reimbursement
Is your practice using the right specialty code to properly capture your work as an interventional radiologist? In the Medicare PECOS system, interventional radiology has its own Medicare specialty code—Code 94. However, many radiology groups continue to use the diagnostic radiology identifier—Code 30—for IRs. This imprecise specialty code could negatively impact IRs as the federal government shifts to the new payment systems mandated by the 2015 Medicare Access and CHIP Reauthorization Act (MACRA).
SIR members should work with their administrators to ensure that your CMS 855 forms and PECOS enrollment are coded as Specialty 94 to ensure accurate quality reporting and payment. See the PECOS for Physicians and Non-Physician Practitioners Fact Sheet — Revised
SIR designed the E/M toolkit to help its members with proper coding and billing of evaluation and management services. There are many more coding and reimbursement resources within the health policy page.
Medicare established a national definition of a global surgical package to ensure that Medicare Administrative Contractors (MACs) make payments for the same services consistently across all jurisdictions. SIR has prepared references to assist physicians and administrators with common global periods for codes frequently reported by interventional radiologists.Learn more