Ask U.S. Congress to Stop Medicare Funding Cuts

On January 1, 2022, Medicare faces looming cuts that can impact patient access to Medicare services. ASE appreciates the action Congress took in adopting the Consolidated Appropriations Act, that delayed the budget neutrality cuts resulting from changes to the codes for office and outpatient evaluation and management services. However, this cut, and several others, are due to be implemented. Please contact your member of Congress and ask them to prevent:

  • The congressionally enacted 3.75% temporary increase in the Medicare physician fee schedule (PFS) conversion factor to avoid pay cuts associated with budget neutrality adjustments tied to CY2021 PFS policy changes. This results in a pending -3.75% cut across the board to all PFS payments.
  • Expiration of the current reprieve from the -2% sequester stemming from the Budget Control Act of 2011.
  • Imposition of a -4% statutory pay-as-you-go 9(PAYGO) sequester resulting from passage of the American Rescue Plan Act.

These reimbursement decreases come at one of the most financially uncertain times within the Medicare payment history. These steep cuts could have serious financial consequences for physicians who are already under financial distress due to the sustained COVID-19 pandemic.

Please take a minute to email your Member of Congress and urge them to prevent these devastating cuts to echocardiography!

Susan Mayer, MD, FASE
Saint Luke’s Mid America Heart Institute
ASE’s Advocacy Chair and CPT Alternate Advisor

Medicare 2022 Final Payment Policies Released

On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2022 Medicare Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (OPPS) Final Rules. The rules will be posted in the Federal Register no later than November 19, 2021.

Topline Takeaways

  • CMS finalizes payment rate for CPT code +93319
  • Four-year transition period to implement the clinical labor pricing update
  • CMS will extend, through the end of CY 2023, with the inclusion of certain Medicare telehealth services 

CY 2022 Medicare Physician Fee Schedule Final Rule

Conversion Factor & Impact to Echocardiography

Overall, the final CY 2022 PFS conversion factor is $33.59, a decrease of $1.30 from the CY 2021 PFS conversion factor of $34.89. The PFS conversion factor reflects the statutory update of zero percent and the adjustment necessary to account for changes in relative value units (RVUs) and expenditures that would result from our finalized policies. Congress intervened late last year to avert significant Medicare physician payment cuts this year, including providing a 3.75 percent payment increase that will expire at the end of 2021 unless Congress steps in again.

ASE continues to work in coalition with national and state medical societies urging Congress to act before January 1, 2022 to extend the existing 3.75 percent adjustment and prevent a Medicare sequestration, that will result in an across-the-board cut in Medicare provider payments, next year that could total as much as 6.0 percent. 

New Add-on CPT Code and Value for 3D

CMS finalized a work valuation of 0.50 RVUs for CPT code +93319 – 3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography. ASE is pleased that CMS accepted the AMA RUC recommendations for this service and wishes to thank Drs. Susan Mayer, Michael Main, Geoffrey Rose, Piers Barker, and Gregory Ensing for all their hard work. We could not have accomplished this without their efforts.

Clinical Labor Update

For the first time in nearly 20 years, CMS is updating the clinical labor rates that are used to calculate practice expense under the PFS. There will be a four-year transition period to implement the clinical labor pricing update, which will help maintain payment stability and mitigate any potential negative effects on healthcare providers by gradually phasing in the changes over time. ASE appreciates the four-year phase in of these changes to avoid future volatility within the fee schedule.

Telehealth Services under the PFS

CMS will continue to evaluate telehealth services that were temporarily added to the Medicare telehealth services list during the COVID-19 public health emergency (PHE). They have finalized an extension, through the end of CY 2023, for the inclusion of certain telehealth services temporarily added to the Medicare telehealth services list that would otherwise have been removed at the end of the COVID-19 PHE, or December 31, 2021. However, CMS has not officially extended the PHE and acknowledges there is uncertainty regarding the timing of their processes about the end of the PHE.

CY2022 Medicare Hospital Outpatient Prospective Payment Systems (OPPS) Final Rule 

Conversion Factor

In accordance with the Medicare statute, CMS is updating the CY 2022 OPPS payment rates for hospitals that meet applicable quality reporting requirements by 2.0 percent. This update is based on the projected hospital market basket increase of 2.7 percent, reduced by 0.7 percentage point for the productivity adjustment.

Use of CY 2019 Claims Data for CY 2022 OPPS Payment System Rate Setting Due to the PHE

CMS clarified that for the OPPS rate setting process, the best available data is used so that the payment rates can accurately reflect estimates of the costs associated with furnishing outpatient services. Ordinarily, the best available claims data is the most recent set of data, which would be from two years prior to the calendar year that is the subject of rulemaking. However, due to a number of COVID-19 PHE-related factors, CMS believes that the CY 2020 data are not the best overall approximation of expected outpatient hospital services in CY 2022. Instead, CMS believes the CY 2019 data, as the most recent complete calendar year of data prior to the COVID–19 PHE, are generally a better approximation of expected costs for CY 2022 hospital outpatient services for rate setting purposes. As a result, CMS is generally using CY 2019 claims data to set the CY 2022 OPPS payment system rates.

Below are links to CMS Fact Sheets for both rules.

Call for Committee Volunteers Now Open

Are you interested in volunteering for ASE? The Society depends on its members to get involved and advance our mission. Our volunteers help set standards, develop products, create courses, direct subspecialty activities, advocate for echo on the federal and state levels, and so much more. If you are a new volunteer interested in serving on an ASE committee or a member currently serving on a committee and would like to continue to serve, learn more here and complete the Committee Interest Application & Conflict of Interest/Disclosure Agreement.

The application process will remain open through January 4, 2022. The term of service for new appointments will be July 2022 – June 2023.

Register for This Weekend’s Echo Florida Virtual Experience

Register today for Echo Florida Virtual Experience, being presented live this weekend October 30 – 31, 2021. The expert faculty will be joining to answer your questions. Created by Course Director, Linda D. Gillam, MD, FASE, and Co-Director, Matt Umland, ACS, RDCS, FASE, highlights of the course include:

  • Coronary artery disease including stress testing
  • Valvular heart disease
  • Interventional imaging
  • Heart failure (systolic and diastolic) and cardiomyopathy
  • Emerging technologies including contrast, 3D/4D echocardiography, and strain imaging
  • Complex congenital heart disease
  • and more!

The live sessions, including recordings of the Q&A sessions, and additional pre-recorded sessions will be available to you for unlimited on-demand viewing through the ASE Learning Hub starting November 15, 2021 until February 13, 2022. A total of 19.25 CME/MOC credits will be included.

Register today.

Maximizing ImageGuideEcho Registry’s Benefits

ASE is proud to share that its innovative clinical data registry, ImageGuideEchoTM, has recently achieved several noteworthy milestones that directly impact a physicians’ ability to adhere to best care practices and standards within the field of echocardiography. This year alone, the ImageGuideEcho Registry has rapidly accelerated the amount of data contained in the Registry, announced a partnership with IAC to satisfy accreditation requirements for two QI measures, and introduced the Pediatric Module.

One benefit of the Registry is that data can be extracted directly from your institution’s echocardiography reporting platform without ongoing manual input. In this video, ASE Board Member and Registry Committee Co-Chair, Jordan Strom, MD, FASE, explains about the different Data Collection Methods and which can work best for your institution.

Download Your Copy of The Role of Echocardiography in Hypertrophic Cardiomyopathy Poster

This professionally illustrated 16″ x 20″ poster is designed to help clinicians diagnose hypertrophic cardiomyopathy (HCM).

The poster outlines the use of echocardiography in the assessment of HCM, including but not limited to:

  • Evaluating LV systolic and diastolic function
  • Establishing a presence and severity of LVOTO
  • Evaluating the degree and direction of mitral regurgitation
  • Intrinsic structure of the mitral valve and papillary muscle
  • Evaluating the LV apical aneurysm 

This valuable tool was authored by Allison Hays, MD, FASE, and Karan Kapoor, MD, in collaboration with Judy W. Hung, MD, FASE, Dermot Phelan, MD, PhD, FASE, and David H. Wiener, MD, FASE.

Ask U.S. Congress to Stop Medicare Funding Cuts

On January 1, 2022, Medicare faces looming cuts that can impact patient access to Medicare services. ASE appreciates the action Congress took in adopting the Consolidated Appropriations Act, that delayed the budget neutrality cuts resulting from changes to the codes for office and outpatient evaluation and management services. However, this cut, and several others, are due to be implemented. Please contact your member of Congress and ask them to prevent:

  • The congressionally enacted 3.75% temporary increase in the Medicare physician fee schedule (PFS) conversion factor to avoid pay cuts associated with budget neutrality adjustments tied to CY2021 PFS policy changes. This results in a pending -3.75% cut across the board to all PFS payments.
  • Expiration of the current reprieve from the -2% sequester stemming from the Budget Control Act of 2011.
  • Imposition of a -4% statutory pay-as-you-go 9(PAYGO) sequester resulting from passage of the American Rescue Plan Act.
  • Implementation of the clinical labor rates decrease for services for echocardiography in the proposed 2022 PFS practice expense (or at least delay it).

These reimbursement decreases come at one of the most financially uncertain times within the Medicare payment history. These steep cuts could have serious financial consequences for physicians who are already under financial distress due to the sustained COVID-19 pandemic.

Please take a minute to quickly email your member of Congress and urge them to prevent these devastating cuts to echocardiography! Use this link to easily contact them.

Register Today for Echo Florida Virtual Experience

There is still time to register for Echo Florida Virtual Experience, presented live October 30 – 31, 2021, with the outstanding faculty joining to answer your questions. It is important to Course Director, Linda D. Gillam, MD, FASE, and Co-Director, Matt Umland, ACS, RDCS, FASE, that you have access to all of the original content that was planned for the in-person event, so the faculty will be recording all of their presentations. Those recordings, along with everything presented live including the Q&A sessions, will be available to you for unlimited on-demand viewing through the ASE Learning Hub starting November 15, 2021 until February 13, 2022. A total of 19.25 CME/MOC credits (pending approval) will be included.

Download the Program Agenda and Register Today!

Latest JASE Podcast with CSE

Do not miss a special crossover episode between the Canadian Society of Echocardiography (CSE) live journal club and the JASE Podcast.

In this episode, Sarah Blissett, MD, and Sabe De, MD, FASE, join Amer Johri, MD, FASE, to discuss the paper, “Normal Values of Cardiac Output and Stroke Volume According to Measurement Technique, Age, Sex, and Ethnicity: Results of the World Alliance of Societies of Echocardiography Study” by Patel et al., with a special introduction from JASE Editor-in-Chief, Michael Picard, MD. FASE. Learn more about the nuances of assessment of cardiac output and stroke volume based on patient demographics and measurement techniques in this newest edition of the JASE podcast.

If you missed any of the podcasts from the 2021 Summer Series, you can listen to all of the episodes here.

Call For Abstracts – ASE 2022 Submission Now Open

Submit your abstract of original research or clinical cases to be considered for presentation at the premier cardiovascular ultrasound conference of the year, the 33rd Annual ASE Scientific Sessions in Seattle, Washington, June 10-13, 2022. Begin your submission online today! Presenters benefit from dedicated viewing times, a global audience that promotes future collaborative work, eligibility for travel support, and discounted conference registration rates. Visit the ASE 2022 Call for Science for more information. Submission closes Wednesday, February 9, 2022, at 11:59 ET.