4:12 PM Abstract No. 363 Trends in advanced practice provider and physician volume and payments for peripherally inserted central catheters among Medicare beneficiaries from 2010 to 2017

Abstract

To study the utilization of peripherally inserted central catheter (PICC) placement among Medicare beneficiaries and analyze the changing trends in total physician and advanced practice provider (APP) volumes and payments from 2010-2017. Claims from the Medicare Part B Physician/Supplier Procedure Summary Master File (PSPSMF) for the years 2010 to 2017 were extracted using the CPT codes for PICC placement. Total volumes and payment amounts (professional component) by specialty and practice setting were analyzed. Volume for PICC placement by physicians and APPs have steadily declined from 2010-2017 from 243,837 to 149,028 (38.9%). Total payments also decreased from $18,871,291 to $11,079,832 (41.3%). The relative share of placement by interventional radiologist (IRs) declined over that time period (from 77.0%-71.8%) with a corresponding increase in placement volume by APPs (13.6%-18.1%). The average payment (professional component) for IRs and APPs was not significantly changed, $75.18 and $66.02 respectively in 2017. 85% of PICCs were placed for inpatients, and 15% were placed for outpatients. The volume of PICC placement among Medicare beneficiaries has steadily declined since 2010. A sharper decline occurred between 2015 and 2016, correlating with the publication of guidelines, including the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC), recommending more restricted indications for PICCs. APPs have had an increasing role in PICC placement over this time period.