Trends in Medicare Reimbursement within Dermatology: 2011-2021

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Kyle Lauck
Quoc-Bao Nguyen
Adelaide Hebert


Evaluation and management, Medicare, Medicare Part B, Reimbursement, Centers for Medicare and Medicaid Services


Introduction: Recently, the Centers for Medicare and Medicaid services have emphasized increased reimbursement for evaluation and management services with compensatory cuts in procedural services. A paucity of data exists examining reimbursement for evaluation and management and procedural services within dermatology.
Methods: This was a retrospective analysis of databases maintained by the Centers for Medicare and Medicaid Services which aimed at assessing if Medicare reimbursement rates in dermatology followed other specialties studied over time. The Physician/Supplier Procedure Summary File, a total summary of Medicare Part B carrier claims, was queried to find the 20 most common Healthcare Common Procedure Coding System codes performed by dermatologists as well as 10 common evaluation and management codes billed by dermatologists in 2019. The Medicare Physician Fee Schedule look-up tool was queried to extract reimbursement rates for all these codes for the years 2011 through 2021, inclusive. Reimbursements were adjusted for inflation.
Results: For both procedural and evaluation and management codes, an average decline in reimbursement of 9.57% was seen from 2011 to 2021 when adjusted for inflation in healthcare costs. Seven out of ten E/M codes experienced a decline in reimbursement when adjusted for inflation with an average decrease of 8.34%. Fifteen out twenty procedural codes experienced a decline when adjusted for inflation with an average decrease of 10.8%.
Conclusion: The decrease in reimbursement here parallels other specialties in trend but is smaller in magnitude of decline. Future studies may reveal the impact of these trends on providers, practices, and patients.



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