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Trends in Medicare Reimbursement for Interventional Radiology Procedures: 2007-2020
Soryan Kumar1, Aditya Khurana2, Jack Haglin3
1Medical School, The Warren Alpert Medical School of Brown University, Providence, USA.
Purpose:
Declining physician reimbursement has been occurring across multiple specialties due to changes in Medicare legislation, including the Deficit Reduction Omnibus Reconciliation Act (DRA), the Balanced Budget Act, and the Sustainable Growth Rate. The purpose of this study was to evaluate trends in Medicare reimbursement rates for various procedural classes in interventional radiology from 2007 to 2020.
Methods:
Common interventional radiology procedures were selected across multiple procedural classes: gastrointestinal, biliary, urinary, fallopian dilatation, other injection/change/removal, iliac vascular, femoral/popliteal vascular, tibial/peroneal vascular, hepatobiliary, and vascular emergency. The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services was queried for current procedural terminology (CPT) codes to extract reimbursement data. All monetary data were adjusted for inflation using the United States consumer price index (CPI). The compound annual growth rate (CAGR) and average annual change in reimbursement were calculated based on these adjusted trends.
Results:
Aside from urinary and vascular emergency procedures, all other procedural classes experienced decreases in inflation-adjusted Medicare reimbursement from 2007 to 2020. The greatest mean decrease in reimbursement rates was observed in biliary procedures (-$21.25), while the largest mean increase in reimbursement rates was observed in vascular emergency procedures ($3.23). All procedures with increases in reimbursement rates and 36.8% of procedures with decreases in reimbursement rates have a CPT code change between 2007 and 2020.
Conclusion:
After accounting for inflation, reimbursement rates were shown to decline for all procedural classes except for urinary and vascular emergencies. Congressional policies, such as the Deficit Reduction Act (DRA) and the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015, may clarify some of these trends.
Insights
Medicare reimbursement for interventional radiology procedures generally declined between 2007 and 2020, with notable exceptions in urinary and vascular emergency services. This trend impacts physician reimbursement across various procedural classes.
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.
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