Question: What will be the impacts of the 2027 conversion factor on radiology?
Answer: For services furnished by non-APM participants, the conversion factor is proposed to be $32.8409, compared with the 2026 conversion factor of $33.4009. This rate reflects a 0.25% annual update as well as a positive 0.53% budget neutrality adjustment. The American College of Radiology(ACR) concludes that “Both conversion factors see an aggregate decrease due to the expiration of the one-year 2.5% conversion factor increase mandated by statute.” Based on the combined effects of these policy changes, CMS projects that radiology will see a 2% payment increase, nuclear medicine a 2% increase, interventional radiology a 3% increase, and radiation oncology a 3% decrease.
Question: If a patient has rheumatoid arthritis and comes in for a methotrexate injection, do we use the chemotherapy injection code?
Answer: Yes, if we look at the guidelines for chemotherapy administration in the CPT® book they specifically reference that for some drugs we will utilize that series of CPT codes for the administration and treatment of non-cancer diagnoses. It is dependent upon the drug and the qualification of that highly-complex drug or that it is defined as an anti-neoplastic. So, for this question, yes, the methotrexate is going to be coded with a chemotherapy injection code.
(MedLearn Publishing)