News

CMS Clarifies Modifier FY Policy
for CR to DR

The Centers for Medicare & Medicaid Services (CMS) recently released their quarterly update of the Hospital Outpatient Prospective System and clarified their policy regarding the applicability of modifier FY when imaging is performed using both CR and DR technology (multiple views). Modifier FY is to be reported when CR technology is the only technology used to perform the imaging service. If an imaging service has both CR and DR views, then the payment adjustment does not apply and modifier FY does not need to be used. Here is the relevant language from the quarterly update:

"CMS notes that section 1833(t)(16)(F)(ii) refers to an imaging service that is an X-ray taken using computed radiography technology. Where the imaging service is comprised of multiple images that include both X-rays taken using computed radiography technology and images taken using digital radiography, CMS does not believe the payment reduction would apply to that service. Instead, the payment adjustment applies to an imaging service that is an X-ray taken using computed radiography technology where the X-ray taken using computed radiography technology is not combined with digital radiography in the same imaging service."

This CR to DR policy was created by the Consolidated Appropriations Act of 2016, and it reduces Medicare reimbursement for X-rays taken using CR technology by 7% until 2022 and 10% thereafter. The intent is to incentivize a transition to DR technology and save Medicare money. The Consolidated Appropriations Act of 2016 also reduced Medicare reimbursement for film X-rays by 20%. If you perform an X-ray with film, you must use modifier FX.

— Source: AHRA