Decreasing Medicare Reimbursement for Facility-Performed Neurotology Procedures From 2000 to 2024.

IF 1.9 3区 医学 Q3 CLINICAL NEUROLOGY
Otology & Neurotology Pub Date : 2025-08-01 Epub Date: 2025-06-02 DOI:10.1097/MAO.0000000000004524
Julia Jiazhen Shi, Rance J T Fujiwara, Lisa Mary Punnen, Hitomi Sakano, Brandon Isaacson
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引用次数: 0

Abstract

Objective: To understand trends in Medicare reimbursement for neurotology procedures from 2000 through 2024.

Methods: The Physician Fee Schedule (PFS) Look-Up Tool from the Center for Medicare and Medicaid Services was used to assess reimbursement data for relevant otologic/neurotologic Current Procedural Terminology (CPT) codes from 2000 to 2024. All monetary data were adjusted to 2024 U.S. dollars using the U.S. Bureau of Labor Statistics Consumer Price Index. Percent changes in reimbursement were calculated.

Results: The average nominal value of reimbursement for all procedures increased by 11.20% from 2000 to 2024. However, after adjusting for inflation, the average change in Medicare reimbursement was -33.52%. The greatest decrease was in CPT code 69714, which saw a 2024 U.S. dollar -66.43% change. The greatest increase was in CPT code 61798, which saw a 43.43% change. An increase in reimbursement for all CPT codes occurred only in 2024. This increase was associated with the calendar year 2024 PFS final rule, which came into effect on March 9 and increased the PFS conversion factor from $32.7442 to $33.2875. From 2000 to 2024, the PFS conversion factor decreased from $36.6137 to $33.2875.

Conclusion: From 2000 to 2023, Medicare reimbursements for otologic and neurotologic procedures decreased after adjusting for inflation. The only year with an increase in reimbursement was 2024, which saw an increase to the PFS conversion factor. These trends highlight the need for greater awareness of, and agreement on, neurotology reimbursement models among surgeons, policy makers, and facility administrators.

从2000年到2024年,减少医疗保险报销设施执行的神经病学程序。
目的:了解2000 - 2024年神经内科医疗保险报销的趋势。方法:使用医疗保险和医疗补助服务中心的医师收费表(PFS)查询工具评估2000年至2024年相关耳科/神经病学现行程序术语(CPT)代码的报销数据。所有货币数据均采用美国劳工统计局消费者价格指数调整为2024美元。计算报销百分比变化。结果:从2000年到2024年,各手续的平均名义报销额增长了11.20%。然而,在调整通货膨胀后,医疗保险报销的平均变化为-33.52%。跌幅最大的是CPT代码69714,2024年美元汇率下跌66.43%。增幅最大的是CPT代码61798,变化了43.43%。所有CPT代码的报销增加只发生在2024年。这一增长与2024日历年PFS最终规则有关,该规则于3月9日生效,将PFS转换系数从32.7442美元增加到33.2875美元。从2000年到2024年,PFS转换因子从36.6137美元下降到33.2875美元。结论:从2000年到2023年,耳科和神经科手术的医疗保险报销在调整通货膨胀后有所下降。偿还额增加的唯一一年是2024年,这一年PFS换算系数有所增加。这些趋势突出了外科医生、政策制定者和医疗机构管理者对神经科报销模式的认识和共识的需要。
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来源期刊
Otology & Neurotology
Otology & Neurotology 医学-耳鼻喉科学
CiteScore
3.80
自引率
14.30%
发文量
509
审稿时长
3-6 weeks
期刊介绍: ​​​​​Otology & Neurotology publishes original articles relating to both clinical and basic science aspects of otology, neurotology, and cranial base surgery. As the foremost journal in its field, it has become the favored place for publishing the best of new science relating to the human ear and its diseases. The broadly international character of its contributing authors, editorial board, and readership provides the Journal its decidedly global perspective.
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