Utilization and reimbursement of diagnostic cerebral angiograms: A Medicare trends analysis from 2013 to 2020

• Published in: Interventional neuroradiology 2024-02, p.15910199241233333
• Main Authors: Gajjar, Avi A, Covell, Michael M, Muhammad, Najib, Kuo, Cathleen, Sioutas, Georgios S, Salem, Mohamed M, Fras, Sebastian Ivan, Jankowitz, Brian T, Burkhardt, Jan-Karl, Srinivasan, Visish M
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 1591-0199; 2385-2011; 2385-2011
• DOI: 10.1177/15910199241233333

Increasing life expectancy has caused growing concern about maintaining viable neurointerventional practices due to altered Medicare payment structures. This study analyzes the financial trends of three common diagnostic tests for cerebrovascular disease: cerebral digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). Medicare Part B National Summary Data files from 2013 to 2020 were queried by Current Procedural Terminology (CPT) codes for DSA (36221-36228), CTA (70496, 70498), and MRA (70544-70547, 70549). Inflation-adjusted charges and reimbursement were calculated using the U.S. City Average Consumer Price Index for Medical Services. Regression analysis was performed on charges, reimbursement, and volume. A total of 1,519,245 diagnostic procedures were conducted between 2013 and 2020 (782,370 angiograms, 246,603 CTAs, and 490,272 MRAs). A total of $41.005 million was reimbursed by Medicare in 2020 for these diagnostic procedures. The annual percent change in volume for all procedures was -2.90%. From 2013 to 2020, inflation-adjusted: Medicare total physician reimbursement decreased for cerebral angiograms (-4.12%, p = 0.007), CTAs (-2.77%, p = 0.458), and MRAs (-9.06%, p