The effects of the Medicare NCS reimbursement policy: utilization, payments, and patient access

Objective: To determine whether the 2013 nerve conduction study (NCS) reimbursement reduction changed Medicare utilization, payments, and patient access to Medicare physicians, we performed a retrospective analysis of Medicare data (2012-2016 fee-for-service data from the CMS Physician and Other Supplier Public Use File).

 

Methods: Individual billable services were identified by Healthcare Common Procedure Coding System CPT and G codes. Medicare utilization and payments were stratified by specialty and type of service (electrodiagnostic tests, including NCS and electromyography (EMG), and other neurologic procedures). We also assessed access to Medicare physicians using the annual number of unique beneficiaries receiving initial Evaluation and Management (E/M) services.

 

Results: We identified 676,113 Medicare providers included in all analysis years from 2012-2016 (10,599 neurologists, 5,881 physiatrists, and 659,633 other specialties). Comparing 2016 to 2012, 21.1% fewer...