P3814An analysis of Medicare reimbursement rates in cardiology from 2000 to 2018

Abstract

Abstract Background There is a paucity of data regarding financial trends for procedural reimbursement in the field of cardiology. A comprehensive understanding of such trends is important as continued progress is made to advance agreeable reimbursement models in cardiology while maintaining quality of care. Purpose To evaluate monetary trends in Medicare reimbursement rates for 10 commonly utilized cardiology procedures from 2000 to 2018. Methods Reimbursement data was extracted using The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services of the 10 included Current Procedural Terminology (CPT) codes in cardiology. The utilized CPT codes included each of the top two most frequently billed codes in the echocardiology, catheterization, pacemaker, electrophysiology, and device integrations divisions of our local cardiology department during the 2017 calendar year. All monetary data for each code was adjusted for inflation to 2018 US dollars (USD) utilizing changes to the United States consumer price index (CPI). If the code was redefined throughout the study period, the correct replacement code was utilized for each year as defined by the procedure. The R-squared and both the average annual and the total percentage change in reimbursement were calculated based on these adjusted trends for all included procedures. Results After adjusting for inflation, the average reimbursement for all procedures decreased by 38.2% from 2000 to 2018. The greatest mean decrease was observed in transthoracic echocardiogram (−64.4%). The only procedure with an increased adjusted reimbursement rate throughout the study period was biopsy of heart lining (+60.4%). From 2000 to 2018, the adjusted reimbursement rate for all included procedures decreased by an average of 2.8% each year, with an average R-squared value of 0.81, indicating a stable decline throughout the study period. Conclusion This is the first study to evaluate trends in procedural Medicare reimbursement for cardiology. When adjusted for inflation, Medicare reimbursement for included procedures has steadily decreased from 2000 to 2018. Increased awareness and consideration of these trends will be important for policy-makers, hospitals, and surgeons in order to assure continued access to meaningful cardiology care both at the local and global level.