{"title":"The Devaluation of Otolaryngology: An Evaluation of CMS' Involvement in Physician Reimbursement.","authors":"R Peter Manes, Sagar Vasandani","doi":"10.1002/lary.32170","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the rate at which the Relative Value Scale Update Committee (RUC) recommended relative value unit (RVU) values for otolaryngology procedures are accepted by the Centers for Medicare and Medicaid Services (CMS).</p><p><strong>Methods: </strong>The Federal Register (https://www.federalregister.gov) was queried from 1995 to 2021 to identify the annual Medicare Final Rule. Within the Medicare Final Rule, all codes reviewed by the RUC were evaluated by two independent authors. Codes where the American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS) and/or the Triologic Society participated in the valuation were extracted.</p><p><strong>Results: </strong>From 1995 to 2021, 271 codes relating to otolaryngology were surveyed and valued by the RUC. In 201 (74%) of those codes, CMS did not alter the RUC recommended value. CMS did alter the RUC recommended value of 70 (26%) codes. From 1995 to 2008, 91 otolaryngology codes were valued. Eighty (88%) of those values were not altered by CMS. Eleven (12%) values were altered by CMS in the Medicare Final Rule. From 2009 to 2021, 180 otolaryngology codes were valued. One hundred twenty-one (67%) of those values were not altered by CMS. Fifty-nine (33%) of those values were altered by CMS. The difference between the two time periods was significant (p = 0.0002). The reduction by CMS throughout all codes ranged from 2% to 100%, with an average alteration of 5%.</p><p><strong>Conclusion: </strong>CMS is taking an increasing role in altering RUC-approved values for otolaryngology procedures. This has implications for both otolaryngology and all medical societies in terms of how their procedures are valued.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.32170","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the rate at which the Relative Value Scale Update Committee (RUC) recommended relative value unit (RVU) values for otolaryngology procedures are accepted by the Centers for Medicare and Medicaid Services (CMS).
Methods: The Federal Register (https://www.federalregister.gov) was queried from 1995 to 2021 to identify the annual Medicare Final Rule. Within the Medicare Final Rule, all codes reviewed by the RUC were evaluated by two independent authors. Codes where the American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS) and/or the Triologic Society participated in the valuation were extracted.
Results: From 1995 to 2021, 271 codes relating to otolaryngology were surveyed and valued by the RUC. In 201 (74%) of those codes, CMS did not alter the RUC recommended value. CMS did alter the RUC recommended value of 70 (26%) codes. From 1995 to 2008, 91 otolaryngology codes were valued. Eighty (88%) of those values were not altered by CMS. Eleven (12%) values were altered by CMS in the Medicare Final Rule. From 2009 to 2021, 180 otolaryngology codes were valued. One hundred twenty-one (67%) of those values were not altered by CMS. Fifty-nine (33%) of those values were altered by CMS. The difference between the two time periods was significant (p = 0.0002). The reduction by CMS throughout all codes ranged from 2% to 100%, with an average alteration of 5%.
Conclusion: CMS is taking an increasing role in altering RUC-approved values for otolaryngology procedures. This has implications for both otolaryngology and all medical societies in terms of how their procedures are valued.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
