Transition from Traditional X-ray Imaging to Digital Radiography

As part of the Transition from Traditional X-Ray Imaging to Digital Radiography, required by the Consolidated Appropriations Act of 2016, imaging facilities must apply modifier FY (X-ray taken using computed radiography technology/cassette-based imaging) to technical component (TC) and global claims for x-ray exams performed using computed radiography (CR).

Medicare will also continue to reduce by 20% the TC payment for x-ray exams taken using film. The payment reduction for film x-rays began in 2017. Film x-rays must be reported with modifier FX (X-ray taken using film).

Effective January 1, 2018, the technical component of x-ray taken using computed radiography technology/cassette-based imaging) must include the FY modifier. The Medicare payment for the TC of exams that use CR will be reduced by 7% in 2018, and the reduction will increase to 10% in 2023.

CMS has declined to provide a list of codes to which providers should apply modifiers FX and FY.

If the modifier is omitted, the facility will be overpaid, and this overpayment creates a refund obligation for the provider. Physicians utilizing film x-ray or x-ray taken using computed radiography technology for imaging facilities should contact MSN so that the appropriate modifiers can be appended to the claims.

This requirement does not affect the professional component of these services. Note that the beneficiary is not liable for the FX or FY modifier payment reduction.

The official instruction, CR 9727, issued to your MAC regarding this change is available at the following link:

CMS Link



Kim Snyder, CPC

Director, Physician Education

MSN Healthcare Solutions