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June 1, 2015

Medicare Anatomic Pathology Utilization: 2009 through 2013

Recent data, including 2009-2013 Medicare data relating to the cost and utilization of anatomic pathology (AP) services, demonstrates that the GAO report fails to tell the full story about cost and utilization:

  • Colonoscopy utilization—and related anatomic pathology—increased in recent years as the standard of care demanded more frequent screening to detect colon cancer, including the U.S. Preventive Services Task Force grade A rating and the Affordable Care Act’s elimination of cost-sharing in 2011.
  • GI-related AP services grew more slowly in professional settings (physician offices and labs) at an annualized rate of 1.2% from 2009 to 2013, compared to the outpatient hospital setting of 3.5% during that period.
  • Medicare cut the major pathology code for GI-related biopsies by nearly 37% in 2013, resulting in a $300 million reduction in reimbursement for pathology services.
    While GAO examined data from 2004 to 2010, an analysis of more recent data (2009 to 2013) shows overall AP utilization growth declining in recent years.

Filed Under: Pathology Services Utilization

Member Spotlight

For more than 30 years, Akron Digestive Disease Consultants has been providing care for conditions affecting the esophagus, stomach, intestines, colon, liver, pancreas, and gall bladder. The practice currently has five board certified physicians committed to providing outstanding personalized and timely digestive health care.

Learn more at:
www.akrondigestive.com

Become a Member

    Is your practice interested in promoting and preserving accessible, high quality and cost-efficient care in the independent GI medical setting? Contact us today about joining DHPA.

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    Silver Spring, Maryland, 20901
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