Utilization and reimbursement of diagnostic cerebral angiograms: A Medicare trends analysis from 2013 to 2020.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY Interventional Neuroradiology Pub Date : 2024-02-22 DOI:10.1177/15910199241233333

Avi A Gajjar, Michael M Covell, Najib Muhammad, Cathleen Kuo, Georgios S Sioutas, Mohamed M Salem, Sebastian Ivan Fras, Brian T Jankowitz, Jan-Karl Burkhardt, Visish M Srinivasan

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Abstract

Introduction: Increasing life expectancy has caused growing concern about maintaining viable neurointerventional practices due to altered Medicare payment structures. This study analyzes the financial trends of three common diagnostic tests for cerebrovascular disease: cerebral digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance angiography (MRA).

Methods: Medicare Part B National Summary Data files from 2013 to 2020 were queried by Current Procedural Terminology (CPT) codes for DSA (36221-36228), CTA (70496, 70498), and MRA (70544-70547, 70549). Inflation-adjusted charges and reimbursement were calculated using the U.S. City Average Consumer Price Index for Medical Services. Regression analysis was performed on charges, reimbursement, and volume.

Results: A total of 1,519,245 diagnostic procedures were conducted between 2013 and 2020 (782,370 angiograms, 246,603 CTAs, and 490,272 MRAs). A total of $41.005 million was reimbursed by Medicare in 2020 for these diagnostic procedures. The annual percent change in volume for all procedures was -2.90%. From 2013 to 2020, inflation-adjusted: Medicare total physician reimbursement decreased for cerebral angiograms (-4.12%, p = 0.007), CTAs (-2.77%, p = 0.458), and MRAs (-9.06%, p < 0.001). Procedural volume billed to Medicare decreased for cerebral angiograms (-4.63%, p = 0.007) and MRAs (-2.94%, p = 0.0.81) and increased for CTAs (+3.15%, p = 0.004). The greatest increase in Medicare reimbursement (+66.75%) came from CPT code 36224, "place catheter carotid artery", and the greatest decrease in Medicare reimbursement (-8.66%) came from CPT code 36226, "place catheter vertebral artery."

Conclusions: This study provides an analysis of Medicare reimbursement trends for routine cerebrovascular angiogram techniques. The findings highlight a decline in Medicare reimbursements for neurointerventionalists.

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诊断性脑血管造影的使用和报销：2013 年至 2020 年医疗保险趋势分析。

简介：由于医疗保险（Medicare）支付结构的改变，预期寿命的延长使人们越来越担心神经介入治疗能否维持下去。本研究分析了脑血管疾病三种常见诊断检查的财务趋势：脑数字减影血管造影术（DSA）、计算机断层扫描血管造影术（CTA）和磁共振血管造影术（MRA）：通过当前程序术语 (CPT) 代码查询了 2013 年至 2020 年的医疗保险 B 部分国家汇总数据文件，包括 DSA (36221-36228)、CTA (70496, 70498) 和 MRA (70544-70547, 70549)。采用美国城市医疗服务平均消费价格指数计算通货膨胀调整后的收费和报销。对收费、报销和数量进行了回归分析：2013年至2020年期间，共进行了1,519,245例诊断程序（782,370例血管造影、246,603例CTA和490,272例MRA）。2020 年，医疗保险为这些诊断程序共报销 4100.5 万美元。所有手术量的年百分比变化为-2.90%。从 2013 年到 2020 年，经通货膨胀调整后：医疗保险对脑血管造影（-4.12%，P = 0.007）、CTA（-2.77%，P = 0.458）和 MRA（-9.06%，P 结论）的医生报销总额有所下降：本研究对常规脑血管造影技术的医疗保险报销趋势进行了分析。研究结果表明，医疗保险对神经介入医师的报销额度有所下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

3.60

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...