Declining Medicare Reimbursement for Diagnostic Radiology: A 10-Year Analysis Across 50 Imaging Studies

Abstract

IntroductionThe aim of this study was to investigate trends in Medicare reimbursement from 2011 to 2021 for common diagnostic imaging studies, both at the individual study level and stratified by imaging modality. MethodsThe 50 most common imaging studies in diagnostic radiology were identified and the global reimbursement data from the Center of Medicare and Medicaid Services for each study was extracted from 2011 to 2021. The reimbursement rates were adjusted for inflation and assessed as a function of time for each individual study and by imaging modality. ResultsThere was a combined mean reduction of inflation adjusted payments of 44.4% across all included imaging studies from 2011 to 2021. Only 3 out of 50 studies saw an increase in adjusted reimbursement during this time. Linear regression analysis revealed that the total mean adjusted reimbursement overall has significantly declined over time (R2 = 0.78, P = 0.0003). The pooled adjusted yearly percent change was also investigated, and an increase in reimbursement was only seen from 2016 to 2017 (+ 0.2%). The period with the steepest decline was in 2013 to 2014 (-16%). The overall yearly percent change was -5.5%. Lastly, reimbursement was stratified by imaging modality. MRI (-60.6%), CT (-44.4%), ultrasound (-31.3%), and radiographs (-6.2%) all experienced a mean decline in reimbursement, though at significantly different severities (P <0.0001). An evaluation of wRVUs during the study period revealed a decline from a mean value of 0.79 to 0.78 wRVUs (-1.3%). ConclusionDiagnostic radiology has experienced significant reimbursement cuts over the past decade, most severely among cross sectional modalities. This data further characterizes reimbursement trends for the field and suggests the need for sustainable future reimbursement schedules.