Valuing the professional work of diagnostic radiologic services

The challenges to the technical component (TC) of radiology services as a result of the Deficit Reduction Act of 2005 have been widely publicized, but a number of regulatory changes will affect the professional component (PC) of our physician work. The third 5-year review is complete, and although there were no major reductions in work relative value units (RVUs) for radiology, proposed budget-neutrality adjustments to physician work RVUs will potentially reduce payments for both the PC and global payments. Additionally, if there is no congressional intervention, reductions in the conversion factor will further decrease Medicare payments. In the article, the history of the radiology relative value scale and the methodology of American Medical Association/Specialty Society Relative Value Scale Update Committee's valuation of physician work are reviewed. The results of the third 5-year review are presented. Future challenges to radiology physician work valuation are discussed, including outsourcing, the Medicare Payment Advisory Commission's search for overvalued services, and the bundling of physician services. Whereas the TC is compensation for performing a diagnostic test, ultimately, it is our physician work that defines our specialty, and challenges to our physician work will be vigorously defended by the ACR without compromise.