Cuts to the Medicare budget may be the most threatening surgery of all for patients in need of medical imaging services.

Congress made deep cuts earlier this year in reimbursement for many medical imaging services that Medicare patients receive in physician offices and independent imaging centers.

Experts fear these cuts will mean less access and higher costs for many patients, especially those in rural areas.

Congress, say advocates, should impose a two-year moratorium on the cuts in order to more fully understand their impact on patients.

Starting in 2007, imaging services will be reduced by Congress by some $8 billion over 10 years. Those reductions represent more than one-third of the total Medicare cuts in the 2005 Deficit Reduction Act.

The payment reductions affect a wide range of medical procedures and tests provided in physician offices and imaging centers. For example, reimbursement would be cut:

35 percent for ultrasound to guide less-invasive breast biopsies;

50 percent for PET/CT scans used for diagnosing and managing tumors;

40 percent for bone density studies for diagnosing osteoporosis; and

42 percent for MR angiography that detects aneurysms in the head.

Given the size of these and similar cuts, advocates warn that many physicians will likely discontinue or cut back on the imaging they provide in independent imaging centers or their own offices. If this happens, patients will have to seek these services at hospitals, which can be much further away and often involve higher out-of-pocket costs for patients. As a result, convenient access to services that many Medicare patients rely on will no longer be available.

Its believed that patients in rural areas are likely to be the hardest hit.

Unfortunately, say advocates such as the Access to Medical Imaging Coalition, these reductions were made without public hearings, public debate or open discussion. The reductions were made without public participation, even though they will likely affect the lives of many Medicare beneficiaries.

Instead, the Coalition believes Congress should impose a two-year moratorium on imaging cuts, so the Government Accountability Office can study the issue.