Dominguez JL, Ederaine SA, Haglin JM, Aragon Sierra AM, Barrs DM, Lott DG. Medicare Reimbursement Trends for Facility Performed Otolaryngology Procedures: 2000-2019.
Laryngoscope 2020;
131:496-501. [PMID:
32619309 DOI:
10.1002/lary.28749]
[Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/22/2020] [Accepted: 04/28/2020] [Indexed: 11/08/2022]
Abstract
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.
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