Mayo Clinic Alix School of Medicine, Scottsdale, Mayo Clinic, AZ.
Department of Emergency Medicine, Mayo Clinic, Rochester, MN.
Ann Emerg Med. 2020 Nov;76(5):615-620. doi: 10.1016/j.annemergmed.2020.06.017.
The change in reimbursement rates for emergency physician services has yet to be quantified. We attempted to fill this knowledge gap by evaluating the monetary trends in Medicare reimbursement rates over the last 20 years for the most common emergency medicine services.
We obtained commonly used Current Procedural Terminology (CPT) codes in emergency medicine from the American College of Emergency Physicians website. We queried the Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services for each of the included CPT codes, and we extracted reimbursement data. We adjusted all monetary data for inflation to 2020 US dollars by using changes to the United States consumer price index. Both the average annual and the total percentage change in reimbursement were calculated on the basis of these adjusted trends for all included services.
Reimbursement by Medicare for the services decreased by an average of 29.13% from 2000 to 2020 after adjusting for inflation. There was a stable decline in adjusted reimbursement rates throughout the study period, with an average decrease of 1.61% each year. The largest decrease was seen for laceration repairs up to 7.5 cm, with reimbursement rates for all 4 relevant CPT codes decreasing by more than 60%.
When adjusted for inflation, Medicare reimbursement declined by an average of 29% over the last 20 years for the 20 most common emergency medicine services. Knowledge of these trends is essential to address current controversies in emergency medicine billing adequately and advocate for sustainable payment system reform.
急诊医师服务的报销费率变化尚未量化。我们试图通过评估过去 20 年 Medicare 报销率在最常见的急诊医学服务方面的货币趋势来填补这一知识空白。
我们从美国急诊医师学院网站获取了急诊医学中常用的现行医疗程序术语（CPT）代码。我们向医疗保险和医疗补助服务中心的医师费用表查询工具查询了包含的每个 CPT 代码的报销数据。我们通过使用美国消费者价格指数的变化将所有货币数据调整为 2020 年的美元。根据所有包含服务的这些调整趋势，计算了报销的平均年度和总百分比变化。
经通货膨胀调整后，2000 年至 2020 年期间，Medicare 对这些服务的报销平均下降了 29.13%。在整个研究期间，调整后的报销率稳定下降，平均每年下降 1.61%。最大的降幅出现在 7.5 厘米以内的裂伤修复，所有 4 个相关 CPT 代码的报销率下降超过 60%。
经通货膨胀调整后，过去 20 年来，Medicare 对 20 种最常见的急诊医学服务的报销平均下降了 29%。了解这些趋势对于充分解决当前急诊医学计费方面的争议并倡导可持续的支付系统改革至关重要。
