CR2DR Legislation FAQ’s

What is the new legislation?

The new legislation goes by HR2029 or the Consolidated Appropriations Act of 2016 or the Omnibus Bill of 2016.

Is it a law?

Yes, it was passed into law on 12/18/2015 – Public Law 114-113. 1

How does this new legislation impact Medical Imaging?

  • The Act incentivizes the transition from “traditional” analog x-ray to digital radiography (DR) by reducing the Medicare hospital outpatient prospective payment system (OPPS) and physician fee schedule payments by 20% beginning in 2017 for Film.2
  • In addition, starting in 2018 ,OPPS and physician fee schedule payments for the technical component will be reduced by 7% for x-ray taken using CR (computed radiography). CR payments will be reduced by 7% from 2018 through 2022. Starting in 2023, penalties will be 10%.2
  • The Act also reduces the discount in payment for the professional component of multiple imaging services provided on or after January 1, 2017 from 25% to 5%.2
  • Section 179 tax deduction (capital depreciation) is permanently extended. The deduction limit is $500,000. This deduction is good for new and used equipment.2
  • Lastly, the Act imposes a Two (2) Year moratorium on the 2.3% Medical Device Excise Tax2

Who does this impact?

This applies to BOTH Hospital OPPS (Outpatient Prospective Payment System) and Private Practice Physicians’ Medicare Physician Fee Schedule (MPFS).3

It is estimated there are roughly 8,000 CR systems still in use in US Hospitals representing almost 50% of the general x-ray systems installed from 2010-2015.

A much smaller amount still use Film.4

How will this be tracked?

It is anticipated that CMS will create a modifier to ensure that cuts only apply to claims using these older technologies, similar to the XR-29 regulation.

Have Private Payors made this change as well?

Not yet but is expected they follow CMS’ lead.

Are there reasons to convert from CR to DR regardless of the legislation?

Yes.

  • Patient Dose Reduction – DR system lowers the radiation dose by nearly 36% compared to CR.5With Samsung, Lower Patient Dose and Image Sharpness with S-Detector:
    Advanced S-Detector – Displays anatomical structure clearly and vividly with Detective Quantum Efficiency (DQE).
    • Dose Area Product (DAP) – Provides patient-level dose estimates and maximum recommended exposure.
    • Automatic Exposure Control (AEC) – Reduces excessive patients’ radiation exposure.
  • Increased Throughput and Workflow Efficiency – ease of use faster image processing means higher throughput. DR system allows users to simplify their daily routines. With DR system, workflow is three times faster than with CR system. By reducing workflow steps, it reduces cost and time while increasing productivity.With Samsung, you’ll experience Enhanced Workflow and Throughput:
    3-Step Workflow – GR40CW allows users to simplify their daily routines. Workflow is three times faster than with a CR system. By reducing workflow steps, it reduces cost and time while increasing productivity.
    • Thin, lightweight S-Detector – Mobility of wireless S-Detector provides higher throughput, making the patients in the procedure more comfortable and convenient.
    • Fast Preview – Preview and full images can be displayed in less than 3 seconds and 10 seconds*, respectively. Previewed images can be reshot or retrieved as full images.
  • Enhanced Image Quality – leading to better patient outcomes.With Samsung, High Quality Images with S-Vue™ provide:
    Improved image sharpness and clarity – Thick and thin parts are clearly distinguished so that overlapping areas and contours are more sharply displayed.
    • Ensured image reliability – Regions of interest are displayed clearly and without artifacts.
    • Great depth and range of image – Highly clarified contrast of the regions of interest provides a clear and detailed display of bones and soft tissues in a single image.

I just purchased CR equipment – is there a trade in?

In many cases recently purchased CR equipment still retains a trade in value toward new DR equipment.

Can you retrofit older analog x-ray equipment instead or replacing the entire room?

Absolutely. With the new retrofit detectors from Samsung – fast and easy upgrade on any make and model x-ray system is available. GR40CW converts your analog/CR system into a superior
DR system. Because GR40CW is the same size as film/CR cassettes, you can upgrade your old equipment to DR system.

If you retrofit an analog room with DR can you upgrade to a Full DR room later?

With Samsung – Yes. Add a DR Retrofit panel now and then, when you’re ready add that panel to a new fully automated DR room.

This conversion may require multiple Capital Budget cycles, are there any programs in place?

Yes. We work with our partner DLL to provide a Bridge to Capital Budget program which allows you to acquire equipment now and delay your payments until capital dollars are available.
You can order your equipment today and postpone your decision to finance or purchase the equipment for up to six months — it’s that simple!

More information?

  • Schedule a Presentation – Lunch & Learn 
  • Schedule an onsite DR Retrofit Demonstration

Sources

  1. http://docs.house.gov/billsthisweek/20151214/CPRT-114-HPRT-RU00-SAHR2029-AMNT1final.pdf
  2. President Obama Signs Spending/Tax Deal with Medicare and ACA Provisions
    https://www.healthindustrywashingtonwatch.com/2015/12/articles/legislative-developments/president-obama-signs-spendingtax-deal-with-medicare-and-aca-provisions/
  3. Medicare x-ray reimbursement cuts on the horizon
    https://www.advisory.com/research/imaging-performance-partnership/the-reading-room/2016/02/x-ray-reimbursement-cuts
  4. Medicare to cut analog x-ray payments starting in 2017
    http://www.auntminnie.com/index.aspx?sec=sup&sub=xra&pag=dis&ItemID=113334
  5. Research, Comparison of Eight Different Digital Chest Radiography Systems : Variation in Detection of Simulated Chest Disease, Lucia J.M.Kroft, August 12, 2004, 344 page

Learn more about the Omnibus Bill’s Impact