Medicare reimbursement for interventional pain procedures: 2000 to 2023.

BACKGROUND

An analysis of the financial trends of Interventional Pain (IP) procedures in the United States is lacking. Understanding these relations is necessary to help optimize future IP care delivery and costs.

OBJECTIVE

To examine Medicare reimbursement trends for IP procedures in both facility and non-facility settings.

METHODS

Utilizing the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid, reimbursement data for 32 of the most performed IP procedures was collected between 2000 and 2023 for both facility and non-facility clinical sites. After adjusting for inflation, annual change, total percent change, and compound annual growth rate (CAGR) were calculated for each procedure.

RESULTS

Following inflation adjustments, the average reimbursement rate decreased by an average of 61.31 % for facility procedures over the study period and by 60.40 % for non-facility procedures. The average adjusted reimbursement rate for facility procedures decreased by $6.76 per year with an average CAGR of -4.38 %, while the average adjusted reimbursement rate for non-facility procedures decreased by $18.66 per year with an average CAGR of -4.48 %. A two-tailed -test was performed between facility and non-facility groups for total percent change (P = 0.803), annual change ( < 0.001), and CAGR ( = 0.746).

CONCLUSION

Medicare reimbursement rates in both facility and non-facility settings have decreased from 2000 to 2023, with non-facility procedures experiencing a significantly larger decrease.