Author ORCID Identifier
Document Type
Article
Publication Date
7-12-2023
Abstract
Objective: The purpose of this study is to characterize Medicare reimbursement trends for laryngology procedures over the last two decades. Methods: This analysis used CMS' Physician Fee Schedule (PFS) Look-Up Tool to determine the reimbursement rate of 48 common laryngology procedures, which were divided into four groups based on their practice setting and clinical use: office-based, airway, voice disorders, and dysphagia. The PFS reports the physician service reimbursement for “facilities” and global reimbursement for “non-facilities”. The annual reimbursement rate for each procedure was averaged across all localities and adjusted for inflation. The compound annual growth rate (CAGR) of each procedure's reimbursement was determined, and a weighted average of the CAGR for each group of procedures was calculated using each procedure's 2020 Medicare Part B utilization. Results: Reimbursement for laryngology procedure (CPT) codes has declined over the last two decades. In facilities, the weighted average CAGR for office-based procedures was −2.0%, for airway procedures was −2.2%, for voice disorders procedures was −1.4%, and for dysphagia procedures was −1.7%. In non-facilities, the weighted average CAGR for office-based procedures was −0.9%. The procedures in the other procedure groups did not have a corresponding non-facility reimbursement rate. Conclusion: Like other otolaryngology subspecialties, inflation-adjusted reimbursements for common laryngology procedures have decreased substantially over the past two decades. Because of the large number of physician participants and patient enrollees in the Medicare programs, increased awareness and further research into the implications of these trends on patient care is necessary to ensure quality in the delivery of laryngology care. Level of Evidence: NA Laryngoscope, 134:247–256, 2024.
Keywords
economics, healthcare policy, laryngology, Medicare, reimbursement
Publication Title
Laryngoscope
Rights
© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Department/Center
Otolaryngology
Recommended Citation
Xu, J.R., Lorenz, R.R., Mulligan, K.M., Otteson, T.D., Maronian, N.C., Manes, R.P., Lerner, M.Z. and Bryson, P.C. (2024), A Medicare Physician Fee Schedule Analysis of Reimbursement Trends in Laryngology from 2000 to 2021. The Laryngoscope, 134: 247-256. https://doi.org/10.1002/lary.30874