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- W2022145573 abstract "The cost of care in radiation oncology has increased in the contemporary era. We investigated trends in the utilization of and payments for radiation oncology services. We used the Centers for Medicare and Medicaid Services Physician/Supplier Procedure Summary Master File (PSPSMF) from 2000 to 2009. The PSPSMF is an aggregate of all Medicare Part B claims. We classified billing codes related to radiation therapy into five distinct modalities: brachytherapy (BT), proton therapy (PT), stereotactic body radiation therapy (SBRT) and external beam radiation therapy (EBRT), which we further divided into conventional (CRT) and intensity modulated radiation therapy (IMRT). We defined usage rate as the total number of services from billing codes specific to each modality per 100,000 beneficiaries, and payment as the allowed charge for those aggregated codes. Because we used aggregated billing data instead of individual case data, each modality may differ on the number of charges per case. For instance, a course of EBRT may use 40-100 separate bills while a course of brachytherapy may use less than 10. Thus, we limited evaluation of usage rate to temporal trends rather than comparison between modalities. Some billing codes were not counted, such as weekly radiation treatment management, hyperthermia, special physics consultations, and treatment devices because they are not modality specific. In the 10 year interval between the start of calendar year 2000 through the end of 2009, the usage rate of radiation increased in each modality: BT (19%), PT (13%), and total EBRT (5.9%). Within EBRT, the usage rate of CRT decreased 33% since 2000, while IMRT usage has increased rapidly since the introduction of the billing code for IMRT in 2002, accounting for 46% of total EBRT usage in 2009. Usage of brachytherapy reached its peak in 2002. Overall payments for EBRT have increased 322% from $256 million in 2000 to $1,083 million in 2009. Since 2002, payments for IMRT have increased to $782 million. However, the rate of increase in payments for overall EBRT has slowed in 2007-2009, and in particular, IMRT payments increased only 4.4% from 2007-2008 and decreased 1.6% from 2008-2009. PT and SBRT payments have also increased during this time, but remain a small percentage of overall charges (2% and 1% of EBRT charges in 2009, respectively). Among Medicare beneficiaries treated in the contemporary era, overall usage of radiation oncology services have increased moderately while overall payments have dramatically increased, with the bulk of the increase due to IMRT payments. However, the rate of increase in payments has slowed in the last 2 years as reimbursement for IMRT has been reduced." @default.
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- W2022145573 date "2011-10-01" @default.
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- W2022145573 title "Trends in Radiation Oncology Services in the IMRT Era: Evolving Patterns of Usage and Payments in Medicare Patients from 2000-2009" @default.
- W2022145573 doi "https://doi.org/10.1016/j.ijrobp.2011.06.285" @default.
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