Trends in Medicare Reimbursement for Otology Procedures From 2000 to 2020
Derrek Schartz, Ryan R. McCool
Abstract
OBJECTIVE: The purpose of this study is to investigate the Medicare reimbursement trends for otologic procedures from 2000 to 2020. STUDY DESIGN: Retrospective data analysis using the Physician Fee Schedule Look-Up tool from the Centers for Medicare and Medicaid services. SETTING: Facility performed procedures of the auditory system. PATIENTS: Medicare beneficiaries from 2000 to 2020. INTERVENTIONS: Selected otologic current procedural terminology codes and their respective year-to-year reimbursement data. MAIN OUTCOME MEASURES: Assessment of trends in financial reimbursement. RESULTS: After adjusting for inflation, the total average reimbursement for all procedures saw an average decrease of -21.2% from 2000 to 2020. The average adjusted percent change per year was -1.3% indicating a slow decline in reimbursement over the study period. There was a difference between the adjusted and unadjusted percent change in reimbursement rate during the study period (-21% versus 20.4%, respectively; p < 0.001). Linear regression analysis of the adjusted average reimbursement across all procedures revealed an overall decline from 2000 to 2020 with an R-squared value of 0.85 indicating a decline in reimbursement over time. CONCLUSIONS: After adjusting all data for inflation, there has been a reduction in the average Medicare reimbursement for otology procedures from 2000 to 2020. Compared with previous reimbursement studies on the whole field of otolaryngology, otology has a less severe decline in reimbursement. Knowledge of these reimbursement trends is critical for otologic surgeons and leaders within the field to develop more sustainable reimbursement plans.