ASE Headquarters Closed Nov. 25-26

ASE Headquarters will be closed Thursday, November 25 and Friday, November 26 in observance of the U.S. Thanksgiving Holiday. Normal business hours will resume on Monday, November 29.

US CMS CY 2022 Payment Rates Available for MPFS and HOPD

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.

To view the Final CY 2022 Payment Rates – MPFS and HOPD, please log in to the ASE Member Portal and visit the Advocacy Portal page.

Below are links to CMS Fact Sheets for both rules.

New TEE in Structural Heart Intervention Guideline Now Available Online

Lead author Rebecca T. Hahn, MD, FASE, said, “The new Standards for the Performance of Transesophageal Echocardiographic Screening for Structural Heart Intervention guideline is intended for the Level II or III echocardiographer whose pre-procedural imaging becomes the backbone of structural heart disease (SHD) procedural planning for the heart team. The structured imaging acquisition protocols and extensive figures and tables show examples of the protocols and should benefit all echocardiographers involved in the care of SHD patients. ASE has been an early adopter of the concept that Interventional Echocardiography is a new subspecialty. As with other developing clinical imaging needs, ASE has taken the lead on defining the training and competencies required for Interventional Echocardiography, and has now taken the first step to standardizing the education around this exciting new field with this guideline.” The document is currently an article in press, and will publish in the January 2022 Journal of the American Society of Echocardiography.

Dr. Hahn will present two webinars on this guideline. Save the dates. Registration will open soon!

  • Introduction to the Guidelines and Review of Aortic and Mitral Imaging Protocols: December 15, 2021 – 3:00-4:00 PM ET
  • Guidelines and Review of Tricuspid and Interatrial septum/LAA Imaging Protocols: December 17, 2021 – 2:30-3:30 PM ET

Upcoming Webinar: The Achilles’ Heel of Fetal Echocardiography: Predicting Postnatal Physiology In Fetal Coarctation and the Borderline Left Heart

Register today for the upcoming webinar, “The Achilles’ Heel of Fetal Echocardiography: Predicting Postnatal Physiology In Fetal Coarctation and the Borderline Left Heart” on Thursday, December 9 from 8:30 PM ET – 9:30 PM ET. Join moderators, Craig Fleishman, MD, FASE and Chris Lindblade, MD, with panelists, Bhawna Arya, MD, FASE; Shuping Ge, MD, FASE; Shaine Morris, MD, MPH, FASE; Ritu Sachdeva, MBBS, FASE; and Michelle Udine, MD.

ASE’s Pediatric Council, in conjunction with the Fetal Heart Society, is pleased to host this webinar on the following topics:

  • A Case Presentation of Fetal and Neonatal COA with Borderline Small Left Heart
  • Challenges in Predicting Postnatal Outcomes of Fetal Coarctation of Aorta
  • Role of Hyperoxia Testing in the Evaluation of Arch Obstruction and the Borderline Left Heart
  • Postnatal Imaging of the Hypoplastic Aortic Arch to Guide Surgical Intervention

The webinar will be followed by a Panel Discussion and audience Q&A. Register here today: https://bit.ly/30bvThS.

Echo VOL | 10 Issue 1

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Submit Your Abstract for ASE 2022

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.

Nominations Closing Soon for Feigenbaum Lecture

Do you have a peer who deserves recognition for the high level of their cardiovascular research? Named in honor of the founder and first president of ASE, Harvey Feigenbaum, MD, FASE, the Feigenbaum Lectureship is awarded to a young investigator in recognition of their significant contributions to research in the field and their potential to continue at a high level of achievement. This Lectureship is open to both physicians and sonographers. The ASE Awards Committee is now accepting nominations for the 2022 Feigenbaum Lecturer who will present during the 33rd Annual ASE Scientific Sessions, June 10-13, 2022 in Seattle, WA. The deadline for nominations is November 30, 2021.

Click here for nomination guidelines. Please email Nominations@ASEcho.org with any questions or to submit your nomination.

Call for Officers and Board Nominations Open

ASE is seeking the best and brightest members to move forward the mission and goals of the Society and the ASE Foundation. Now is your opportunity to become a leader. If you meet the criteria outlined on the Open Positions and Criteria web page, you will need to ask a friend or colleague, who is also an active ASE member, to submit a nomination on your behalf.

The process is easy, and guidelines for submitting nominations are available here. The deadline for submission of nominations is November 30, 2021. Ask an active ASE member TODAY to submit your nomination.

Please contact Nominations@ASEcho.org with any questions or to submit nominations.

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.