CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
Patrick Godbey, MD
October 2020—Many CAP TODAY readers know about my fondness for horse racing, so it will come as no surprise that I thoroughly enjoyed the belated running of the Kentucky Derby last month. I even made a few dollars from a small bet, which may be the only positive financial news I get in a year marked by COVID-19 and the threat of impending reimbursement cuts.
I wrote about these cuts last month, but since they represent one of the most potentially damaging situations for health care, I feel they merit another column. This summer, we learned that the Centers for Medicare and Medicaid Services plans to greatly cut payments for pathology and other services. The planned cut overall for pathology is nine percent with a 12.5 percent cut for the 88305–26. The cut is based on a budget neutrality requirement and is intended to offset reimbursement increases for other types of health care services.
Dr. Godbey
Pathologists are not alone in facing this possible cut. It would hit all physicians who do not typically bill evaluation and management (E/M) codes—that includes general surgeons, ER doctors, urgent care doctors, radiologists, anesthesiologists, and more. The CAP, in coordination with dozens of other organizations, is actively lobbying Congress to waive the budget neutrality requirement in order to avoid these cuts.
If we are not successful, pathologists will feel the pain of these reimbursement changes. But make no mistake: The biggest problem with these cuts is that they will contribute to reduced access to health care for many Americans, including those in our most vulnerable communities.