Medicare Proposing to Cut Payment for Diagnostic Mammogram

The Medicare program is proposing to cut its payment for a diagnostic mammogram by 7.5 percent despite complaints that current rates are too low.

The Centers for Medicare and Medicaid Services is planning to pay hospitals $32.54 next year -- down from the current rate of $35.17. The new rates would go into effect Jan. 1, 2002.

The proposed rates apply only to diagnostic mammograms performed in hospitals -- not the screening mammograms which look for possible signs of cancer. The rates also only apply to payments to hospitals. The doctor performing the exam gets a separate fee.

The American College of Radiology has estimated that it costs a hospital $97.48 to perform a routine mammogram, which is less complex than the diagnostic procedure

The proposed Medicare payment cut follows a year of complaints that payment rates do not cover the costs of mammograms, leading centers offering mammograms to close and forcing women to wait months for the tests.

Linda Frame of the Susan G. Komen Breast Cancer Foundation said there currently are 9,600 certified mammography facilities in the United States -- down from 9,873 in March.

"Hospitals will be forced to re-evaluate whether they can afford to continue absorbing the losses incurred by providing this critical health service," said William T. Thorwarth Jr. of the American College of Radiology.

Other Sources: CMS, Wall Street Journal