Medicare Reimbursement Trends for Facility Performed Otolaryngology Procedures: 2000-2019.

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Tytuł:: Medicare Reimbursement Trends for Facility Performed Otolaryngology Procedures: 2000-2019.
Autorzy:: Dominguez JL; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A.
Ederaine SA; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A.
Haglin JM; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A.
Aragon Sierra AM; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A.
Barrs DM; Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona, U.S.A.
Lott DG; Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona, U.S.A.
Źródło:: The Laryngoscope [Laryngoscope] 2021 Mar; Vol. 131 (3), pp. 496-501. Date of Electronic Publication: 2020 Jul 03.
Typ publikacji:: Evaluation Study; Journal Article
Język:: English
Imprint Name(s):: Publication: <2009- >: Philadelphia, PA : Wiley-Blackwell
Original Publication: St. Louis, Mo. : [s.n., 1896-
MeSH Terms:: Ambulatory Surgical Procedures/*economics
Insurance, Health, Reimbursement/*trends
Medicare/*trends
Otolaryngology/*economics
Otorhinolaryngologic Surgical Procedures/*economics
Aged ; Aged, 80 and over ; Current Procedural Terminology ; Databases, Factual ; Humans ; United States
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Contributed Indexing:: Keywords: Economics, physician payment, relative value units, healthcare policy
Entry Date(s):: Date Created: 20200704 Date Completed: 20210301 Latest Revision: 20210301
Update Code:: 20240105
DOI:: 10.1002/lary.28749
PMID:: 32619309
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Objective: There is a paucity of data regarding financial trends for procedural reimbursements in otolaryngology. The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for the 20 most commonly billed otolaryngology procedures from 2000 to 2019.
Study Design: Analysis of physician reimbursement.
Methods: The American Academy of Otolaryngology-Head and Neck Surgery database was queried to determine the 20 most performed otolaryngology procedures. Next, the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services was utilized to assess each of the top 20 most utilized Current Procedural Terminology (CPT) codes in otolaryngology, and reimbursement data was extracted. All monetary data was adjusted for inflation to 2019 U.S. dollars using changes to consumer price index. Average annual and total percentage change in reimbursement were calculated based on adjusted values for all included procedures.
Results: After adjusting for inflation, the average reimbursement for the total 20 procedures decreased by 37.63% from 2000 to 2019. The greatest single mean decrease was seen in CPT code 61782 for stereotaxis procedures on the skull, meninges, and brain (-59.96%), whereas the smallest mean decrease was in CPT code 30520 for septoplasty (-1.50%). From 2000 to 2019, the adjusted reimbursement rate for the combined procedures decreased by an average of 2.33% each year.
Conclusion: Medicare reimbursement for included procedures has decreased from 2000 to 2019. Increased awareness and consideration of these trends will be important for policy makers, hospitals, and surgeons in order to assure continued access to meaningful otolaryngology care in the United States.
Level of Evidence: 4 Laryngoscope, 131:496-501, 2021.
(© 2020 The American Laryngological, Rhinological and Otological Society, Inc.)

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