Trends in Medicare utilization and reimbursement for hematology/oncology procedures from 2012 to 2023: A geriatric oncology perspective

Author:

Conic J.1ORCID,Reske T.2

Affiliation:

1. Department of Internal Medicine, Section of Geriatric Medicine Louisiana State University Health Sciences Center New Orleans Louisiana USA

2. Department of Internal Medicine, Section of Geriatric Medicine and Section of Hematology/Oncology Louisiana State University Health Sciences Center New Orleans Louisiana USA

Abstract

AbstractObjectivesGiven the scarcity of data exploring reimbursement trends in the field of hematology/oncology, we sought to characterize these trends for common procedures in this field from 2012 to 2023.MethodsUsing the Centers for Medicare and Medicaid Services' Physician Fee Schedule Look‐Up Tool we collected reimbursement data for 40 hematology/oncology procedure codes from 2012 to 2023. Data was adjusted to 2023 United States (US) dollars using the Consumer Price Index (CPI).ResultsFrom 2012 to 2023 gross reimbursement for the facility price decreased 4.4% and increased 9.2% for the non‐facility price. When adjusted for inflation, compensation decreased 96.1% and 96.6%, respectively. None of the 40 examined Current Procedural Terminology (CPT) codes increased in net reimbursement over the study period.ConclusionsMedicare reimbursement for common hematology/oncology procedures decreased from 2012 to 2023. Further research is necessary to explore the implications of these trends on the delivery of patient care.

Publisher

Wiley

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