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Trends of Medicare Reimbursement Rates for Gender-Affirming Surgery Procedures
Justin J Cordero1, Leonardo Alaniz2, Sandhya Kalavacherla3
1From the School of Medicine, University of California Riverside, Riverside.
Annals of Plastic Surgery
|May 1, 2024
Summary
Medicare reimbursement for gender-affirming surgery has declined significantly since 2014. Surgeons treating transgender patients should be aware of these decreasing rates and advocate for improved compensation.
Area of Science:
- Health Economics
- Surgical Outcomes
- Health Policy
Background:
- Medicare coverage for gender-affirming surgery began in 2014.
- Understanding Medicare reimbursement is crucial for surgeons serving transgender patients.
Purpose of the Study:
- To analyze trends in Medicare reimbursement rates for gender-affirming surgery procedures.
- To compare reimbursement from 2014 to 2022.
Main Methods:
- Utilized the Medicare Physician Fee Schedule Look-Up Tool.
- Analyzed 43 gender-affirming surgery Current Procedural Terminology codes.
- Assessed monetary units, conversion factors, and relative value units (RVUs) for work, facility, and malpractice, adjusting for inflation.
Main Results:
- Average reimbursement decreased by 2.99% between 2014 and 2022.
- Work-based RVU charges decreased by 3.97% for transmasculine and 1.73% for transfeminine procedures.
- Inflation-adjusted reimbursement decreased by 23.42% overall.
Conclusions:
- Medicare reimbursement rates for gender-affirming surgery have declined.
- Reimbursement trends have not kept pace with inflation.
- Surgeons should advocate for equitable compensation to support care for an underserved population.
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