PMID- 33331651
OWN - NLM
STAT- MEDLINE
DCOM- 20210603
LR  - 20210603
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 131
IP  - 6
DP  - 2021 Jun
TI  - Compensation Rates for Otolaryngologic Procedures Under the Medicare Physician 
      Fee Schedule in 2018.
PG  - E1785-E1791
LID - 10.1002/lary.29328 [doi]
AB  - OBJECTIVE/HYPOTHESIS: Medicare reimbursement for physician work depends on the 
      estimated time and intensity - which encompasses technical skill, cognitive load, 
      and stress - required to perform services. The Centers for Medicare and Medicaid 
      Services (CMS) quantitatively expresses intensity estimates as compensation rates 
      per unit time. This study aimed to characterize compensation rates under the 
      Medicare Physician Fee Schedule (PFS) for operative procedures commonly performed 
      by otolaryngologists. STUDY DESIGN: This study was a retrospective, 
      cross-sectional analysis. METHODS: This study was a retrospective, 
      cross-sectional analysis of fiscal year 2018 PFS specifications and publicly 
      available Medicare Part B utilization data for the top 100 highest-volume 
      procedures furnished by otolaryngologists to Medicare beneficiaries in inpatient 
      and ambulatory surgical center (ASC) settings between January 1, 2018, and 
      December 31, 2018. Co-primary outcomes were the estimated 1) total compensation 
      rate ($/min) and 2) intraservice (i.e., "skin-to-skin" time) compensation rate 
      ($/min) for each included procedure. RESULTS: The analytic sample included 147 
      unique procedure types (settings non-mutually exclusive): 82 inpatient procedure 
      types (n = 33,907 procedures) and 95 ASC procedure types (n = 34,765 procedures). 
      In the inpatient setting, median total compensation rate and intraservice 
      compensation rates were $1.50/min (interquartile range [IQR]: 
      $1.19/min-$1.65/min) and $2.27/min (IQR: $1.69/min-$2.68/min), respectively. In 
      the ASC setting, median total compensation rate and intraservice compensation 
      rates were $1.48/min (interquartile range [IQR]: $1.27/min-$1.77/min) and 
      $2.39/min (IQR: $1.82/min-$2.91/min), respectively. At the service line level, 
      volume-weighted total (inpatient: $1.91/min, ASC: $1.90/min) and intraservice 
      (inpatient: $3.84/min, ASC: $3.37/min) compensation rates were highest for 
      rhinologic procedures. CONCLUSIONS: Compensation rates under the Medicare PFS 
      varied widely for operative procedures commonly performed by otolaryngologists. 
      LEVEL OF EVIDENCE: NA Laryngoscope, 131:E1785-E1791, 2021.
CI  - (c) 2020 American Laryngological, Rhinological and Otological Society Inc, "The 
      Triological Society" and American Laryngological Association (ALA).
FAU - Kondamuri, Neil S
AU  - Kondamuri NS
AUID- ORCID: 0000-0002-6635-734X
AD  - The Warren Alpert Medical School of Brown University, Providence, Rhode Island, 
      U.S.A.
FAU - Miller, Ashley L
AU  - Miller AL
AD  - Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.
AD  - Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, 
      U.S.A.
FAU - Rathi, Vinay K
AU  - Rathi VK
AD  - Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.
AD  - Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, 
      U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20201217
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Centers for Medicare and Medicaid Services, U.S.
MH  - Cross-Sectional Studies
MH  - *Fee Schedules
MH  - Humans
MH  - Medicare/*economics
MH  - Otolaryngology/*economics
MH  - Practice Patterns, Physicians'/*economics
MH  - Relative Value Scales
MH  - Retrospective Studies
MH  - United States
OTO - NOTNLM
OT  - CMS
OT  - PFS
OT  - RUC
OT  - RVU
OT  - compensation
EDAT- 2020/12/18 06:00
MHDA- 2021/06/04 06:00
CRDT- 2020/12/17 08:43
PHST- 2020/10/19 00:00 [revised]
PHST- 2020/07/01 00:00 [received]
PHST- 2020/12/06 00:00 [accepted]
PHST- 2020/12/18 06:00 [pubmed]
PHST- 2021/06/04 06:00 [medline]
PHST- 2020/12/17 08:43 [entrez]
AID - 10.1002/lary.29328 [doi]
PST - ppublish
SO  - Laryngoscope. 2021 Jun;131(6):E1785-E1791. doi: 10.1002/lary.29328. Epub 2020 Dec 
      17.