Computed Tomography Modifier Reduction List

Starting in 2017, Medicare reduces payment by 15% for certain services furnished using computed tomography (CT) equipment that doesn’t meet specific standards. Section 218(a) of the Protecting Access to Medicare Act of 2014 (PAMA), “Quality Incentives to Promote Patient Safety and Public Health in Computed Tomography Diagnostic Imaging,” amended the Social Security Act (SSA) to require this reduced payment.

When Does Medicare Apply the Reduced Payment?

Medicare reduces payment when the CT equipment used to furnish certain services doesn't meet each of the attributes of the National Electrical Manufacturers Association (NEMA) Standard XR–29–2013, titled ‘‘Standard Attributes on CT Equipment Related to Dose Optimization and Management.’’

What Services Does the Reduced Payment Apply To?

View the CT Modifier Reduction List (ZIP) for a list of applicable services, including CPT codes and short descriptors.

Which Fees Does Medicare Reduce?

The reduced payment applies to the technical component (and the technical component of the global fee) of the Physician Fee Schedule  for applicable services.