GI Reimbursement Being Hammered by Medicare: 15-Year Trends
Douglas K. Rex, MD, MASGE, reviewing Khunte M, et al. Am J Gastroenterol 2022 Sep 16.
This study looked at reimbursement from Medicare for 10 commonly used EGD and colonoscopy codes as well as several inpatient and outpatient services over a 15-year interval.
Overall unadjusted reimbursement for the 10 GI procedures exhibited an average decrease of 7% over 15 years, which was a 33% decrease after adjustment for inflation. The highest decrease in inflation-adjusted reimbursement was a 38% reduction in reimbursement for colonoscopy and biopsy. From 2007 to 2014, the mean decrease in reimbursement was 6.7%, but it was 28.2% from 2015 to 2022.
Unadjusted reimbursement for inpatient and outpatient visits increased an average of 32.1%, but overall reimbursement was much better for outpatient visits than inpatient visits. After adjustment for inflation, patient visit reimbursement showed a mean adjusted decrease of 4.9%.
COMMENTIt’s no wonder that many GI physicians seek membership in practices with income sources other than professional fees. Physicians, particularly academic and employed physicians, relying only on compensation for relative value unit productivity as income are at a significant disadvantage.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Khunte M, Dang N, Zhong A, Kumar S, Kamp K, Shah SA. Changes in Medicare reimbursement for common gastroenterology services over 15 years: 2007-2022. Am J Gastroenterol 2022 Sep 16. (Epub ahead of print) (https://doi.org/10.14309/ajg.0000000000002010)
