Extremely disappointed with ACRO. Vert clueless and *****ic response. In my opinion, his speech at the end underscores the huge necessity for a new leadership group in radiation oncology that truly is neutral and represents the needs of current Radiation Oncologists. He was clearly in bed with Astro given his response. How disappointing.
Is that why Astro was fine with APP supervision with hospital-based all these years without a peep? We know for a fact APP-billed codes don't pay at the same level as physician-billed ones.
I think you may be right.
This is simply incorrect, though.
But, Chicken Little, the sky didn’t fall. For more than 4 years CMS converted the majority of rad onc from direct to general. CMS “review[ed] the codes” in the meantime. The wRVUs did not drop; wRVUs don’t make up the majority of radiation oncology reimbursement anyways*… and to really blow people’s minds, CMS values many rad onc codes not by MD presence but by therapist presence (different topic for a different day).
Right - I would apply that same argument towards ASTRO's position, too.
That’s a long peak. And the direct to general shift had zilch to do with COVID, and CMS never had any reimbursement talk coupled with that shift. And CMS never telegraphed any desire to fiddle with reimbursement in general supervision CAHs pre 2020. Linacs will cost the same and have the same use factors regardless of MD supervision levels.
That’s a long peak. And the direct to general shift had zilch to do with COVID, and CMS never had any reimbursement talk coupled with that shift. And CMS never telegraphed any desire to fiddle with reimbursement in general supervision CAHs pre 2020. Linacs will cost the same and have the same use factors regardless of MD supervision levels.
ALSO… IGRT was under personal supervision from 2006 (when the code first appeared) to 2009. When CMS changed the supervision to a lower direct, the wRVU didn’t change at all. Probably the safety of IGRT was worse though
I doubt it too
How do we have "super favorable billing codes"?
Well they have sucked at maintaining reimbursement right? Much data has been produced showing that CMS has cut rad onc reimbursement by 20% or so the last 20 years.
Salaries of employed radonc are not based on professional codes.
IMRT dropped quickly as it skyrocketed on the list of CMS costs. If you are on the top, you are the target. To CMS credit, IMRT also got easier over time with less equipment/time necessary.
Not really. Your total comp is based on supply and demand and then $/rvu are adjusted. That’s why psych may have the same salary as you with 3500 rvus, and ortho paid a lot more with 8k rvus.
forums.studentdoctor.net
Psych is less desirable locations- where most radonc jobs are available- earns around 400k. Anyway, supply and demand underlies prices/salaries at the end of the day.How much do you make in a year as a psychiatrist?
I think a lot of people get this wrong. Everything is negotiable. You do not have to automatically give your agent 3% to sell your home. Have a multi million dollar home in a nice area? You think you can't tell your agent to take a hike and then find someone else willing to sell your home for 2...
Lets have clarity about the things we speak about
When you talk about IMRT and wRVU about the only thing you can talk about is CPT 77301.
My main point is your salary is much more linked to Astro pumping out residents than cms adjusting proffesional reimbursements. In fact, technical is so high for many large academic centers, that salaries wouldn’t be impacted if proffesional went to O.
When you talk about IMRT and wRVU about the only thing you can talk about is CPT 77301.
In 2003, 77301 had 8.00 wRVUs, reimbursing ~$392.
In 2023, 77301 had 7.99 wRVUs, reimbursing ~$423.
Please don’t bring the valuation of a dollar over time into this discussion
They have been failing plenty. Urologists and rad oncs can still own linacs together, CMS still went to general/virtual, ASTRO was dragged into considering payment bundles now after the freestanding community had been begging for them for decades etc.
Human time and effort, not human location. I literally could virtual at home all morning and never leave my desk/multi monitor workstation
This is such an important point that people seem to be glossing over. I don’t know if it’s because of the recent attention that Bridge Oncology has drawn or ASTRO’s fear mongering efforts, but the change in supervision requirement has been around for over four years and the sky has not fallen. There have been zero reports of safety related issues as result of the change in supervision. As someone else pointed out, the most public safety related issue in radiation oncology recently was the incident at GenesisCare where they treated the wrong breast. This has nothing to do with general versus direct supervision. Additionally, physicians are not running around abusing the supervision laws, at least to my understanding.
Why can’t the “role of the physician” be to oversee four rural centers with the aid of virtual supervision and make 2 million a year while doing so.
The idea that ASTRO is trying to protect the role of radiation oncologists is a fallacy. If ASTRO cared about protecting the role of rad oncs, the simple solution would be not to overtrain our specialty as other specialties have succeeded in doing and have thereby maintained their roles, their job markets, and their competitiveness.
