ARRS 2022 Abstracts

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E1280. A Temporal Assessment on Global Medicare Reimbursement for Diagnostic Radiology: A 10-Year Analysis Across 50 Imaging Studies
Authors
  1. Emily Schartz; Department of Imaging Sciences, University of Rochester Medical Center
  2. Derrek Schartz; Department of Imaging Sciences, University of Rochester Medical Center
Objective:
The aim of this study was to investigate trends in Medicare reimbursement from 2011 to 2021 for common diagnostic imaging studies, both at the individual study level and stratified by imaging modality.

Materials and Methods:
The 50 most common imaging studies across all diagnostic radiology subspecialties were identified along with their respective Current Procedural Technology (CPT) code. The Physician Fee Look-Up Tool from the Center of Medicare and Medicaid Services was then utilized to extract Medicare reimbursement data for each included study from 2011 to 2021 using the global reimbursement modifier. Subsequently, the rate of reimbursement was adjusted for inflation using the Consumer Price Index (CPI) inflation calculator from the U.S. Department of Labor’s Bureau of Labor Statistics. Inflation-adjusted reimbursement rates as a function of time were then determined for each individual study. The studies were also stratified based on modality for further comparison.

Results:
During the 10-year study period, there was a –44.4% mean total decline in reimbursement after adjusting for inflation. Three out of 50 studies saw an increase in adjusted reimbursement over the 10-year study period, including radiograph abdominal 1 view (+2.5%), radiograph hip 2-3 views (+3.3%), and radiograph femur 2 views (+6.0%). The three studies that saw the largest decline in adjusted reimbursement were DEXA bone density axial (–66.2%), MRI brain w/o contrast (-64.1%), and MRI joint lower extremity w/o contrast (–60.8%). Linear regression analysis revealed that the total overall mean adjusted reimbursement has significantly declined over time (R2 = 0.78, p = 0.0003). The mean adjusted yearly percent change was also investigated, and the only period with an increase in reimbursement was 2016–2017 (+0.2%). The period with the steepest mean decline was 2013–2014 (–16%). Overall, the mean adjusted yearly change was –5.5%. Lastly, reimbursement was stratified by imaging modality. MRI (–60.6%), CT (–44.4%), ultrasound (–31.3%), and radiography (–6.2%) experienced a mean decline in reimbursement, though at significantly different severities (p < 0.0001).

Conclusion:
To our knowledge, this is the first study to investigate global Medicare inflation-adjusted reimbursement at the individual study level for a broad range of diagnostic imaging studies. We found that diagnostic radiology has experienced significant reimbursement cuts over the past decade, most severely among cross sectional modalities. These data further characterize reimbursement trends for the field and suggest the need for sustainable future reimbursement schedules.