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CMS Update: Transitioning from Analog X-Ray to Digital X-Ray

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In a September 9th meeting, the American College of Radiology (ACR) asked the Centers for Medicare and Medicaid Services (CMS) to delay the determination of radiology reimbursements for the calendar year 2015 Fee Schedule.  

This request was in response to the method CMS used to estimate capital equipment costs for PACS storage systems. Proposed payments were determined based on the cost of a standard desktop PC as opposed to a true PACS workstation. Clearly, CMS's understanding of the complexity and real costs of PACS is limited, however, the scope of this calculation is far from limited to PACS purchases and management.

The Changes

If you haven't guessed from the lack of exclamation points and smiley emoticons in this blog, the news from CMS wasn't what the ACR or radiology practitioners wanted to hear. The reimbursement numbers for many procedures came back significantly lower. The request made by ACR was denied and CMS finalized the rule provisions in November 2014. As of January 1st, 2015, payments on over 200 reimbursement codes were lowered.

The Catch 22

These changes to the radiology reimbursement structure constitute a continuation of the trend in medicine of requiring physicians and clinics to do more with less. If a facility is going to avoid a blow to their bottom line, they'll need to compensate for reimbursement reductions by either cutting their budget in other areas or scanning a higher volume of patients.

Of course, most facilities would much rather see more patients before they start cutting their budgets. And, given the trend we just mentioned, it's getting harder and harder to find places to cut anyway. This is where lower reimbursements create a catch 22: you need to do more volume to offset reductions, but you need to spend money on equipment upgrades to do more volume.

How Can We Mitigate?

While there is no perfect solution that can add more hours to the day or unilaterally reduce all the other costs of running an imaging center, there is a way to upgrade your equipment's volume capacity without breaking the capital equipment budget in one go: retrofit your analog X-ray system with a digital X-ray detector panel.


Using a digital radiography (DR) panel solves the volume issue with faster scan times. Anyone who has been digitizing their images with CR cassettes will know how much faster it is than using old school film cassettes. Using a DR panel is faster still. Your panel will have an image rendered on your review workstation in about 5 seconds without moving it anywhere. Thanks to improved batteries with longer life and faster recharging, you can also keep scanning this quickly through the entire workday.


DR panels can also help you get the upgrades you need at a price point much more commensurate with declining reimbursements. There are certainly advantages to upgrading all the way to a factory-born digital X-ray room, but if that expense simply isn't within your means right now a DR panel gets you where you need to go in both image quality and scan times. Note the difference in cost below:

DR Panel: $45,250 - $78,500 (varies by make, model, material, wireless vs. tethered)

Digital X-Ray Room: $59,500 - $115,000 (varies by make, model)

The Takeaway

If reimbursement reductions have you concerned, upgrading with a DR panel can help you make up for some of the challenges coming down the line. If you have more questions about DR panels or DR rooms, we'd love to talk through your facility's digital options. Contact us to speak with one of our X-ray experts.

How to plan for a DR panel upgrade >> Use this step-by-step guide to help you compare options and decide which setup is best for you.

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