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Medicare Reimbursement Drives Procedural Over Cognitive Care

Medicare Reimbursement Drives Procedural Over Cognitive Care

Physician reimbursement three to five times higher for common procedures versus cognitive care

WEDNESDAY, Aug. 14 (HealthDay News) -- Physicians treating Medicare patients are reimbursed three to five times more for performing common procedures versus providing cognitive care, according to a study published online Aug. 12 in JAMA Internal Medicine.

Christine A. Sinsky, M.D., from Medical Associates Clinic in Dubuque, Iowa, and David C. Dugdale, M.D., from the University of Washington in Seattle, compared the hourly revenue generated by a physician performing cognitive services (Current Procedural Terminology [CPT] code 99214) and billing by time versus hourly revenue generated by physicians performing screening colonoscopy (Healthcare Common Procedure Coding System code G0121) or cataract extraction (CPT code 66984) for Medicare beneficiaries.

The researchers found that revenue for physician time spent on colonoscopy and cataract extraction procedures was 368 and 486 percent, respectively, of the revenue for a similar amount of physician time spent on cognitive care.

"We demonstrate that two common specialty procedures can generate more revenue in one to two hours of total time than a primary care physician receives for an entire day's work," the authors write.

Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1726999#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1726999 )