Trends in Medicare Reimbursement for Interventional Radiology Procedures: 2007-2020.

Area of Science:

• Interventional Radiology
• Health Economics
• Medicare Policy

Background:

• Physician reimbursement has faced declines due to legislative changes like the Deficit Reduction Omnibus Reconciliation Act (DRA) and the Balanced Budget Act.
• These financial pressures affect multiple medical specialties, necessitating an analysis of their impact on specific fields.

Purpose of the Study:

• To evaluate Medicare reimbursement trends for interventional radiology procedural classes from 2007 to 2020.
• To understand the financial impact of legislative changes on interventional radiology services.

Main Methods:

• Selected common interventional radiology procedures across gastrointestinal, biliary, urinary, vascular, and other classes.
• Extracted reimbursement data using Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule data and Current Procedural Terminology (CPT) codes.
• Adjusted all monetary data for inflation using the US consumer price index (CPI) and calculated compound annual growth rate (CAGR).

Main Results:

• Most interventional radiology procedural classes saw decreased inflation-adjusted Medicare reimbursement from 2007-2020.
• Biliary procedures experienced the largest mean decrease (-$21.25), while vascular emergencies showed the largest mean increase ($3.23).
• Changes in CPT codes were associated with reimbursement increases and 36.8% of reimbursement decreases.

Conclusions:

• Inflation-adjusted reimbursement declined for nearly all interventional radiology procedural classes, excluding urinary and vascular emergencies.
• Congressional policies, including the DRA and the Medicare Access and Children's Health Insurance Program Reauthorization Act, may influence these reimbursement trends.
• Understanding these trends is crucial for the financial sustainability of interventional radiology practices.