Medicare Devalues 40% Of Physician Service Recommendations: 5 Notes


 
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By Ella Jeffries

Medicare’s final valuations were lower than specialty societies’ initial recommendations for 39.9% of physician services examined in a recent study.

Here are five things to know:

1. Researchers examined 2,173 Relative Value Scale Update Committee recommendations covering 1,934 unique CPT codes from 2004 to 2025, excluding 2011 and 2012.

2. The RUC left 1,664 specialty society proposals unchanged, or 76.6%. Among its 509 adjustments, 482, or 94.7%, were devaluations.

3. CMS left 1,436 RUC proposals unchanged, or 66.1%. Of its 737 adjustments, 488, or 66.2%, were devaluations and 249, or 33.8%, were upvaluations.

4. From specialty societies’ initial proposals through CMS’ final valuations, 1,114 recommendations, or 51.3%, were unchanged; 846, or 39.9%, were devalued; and 213, or 9.8%, were upvalued.

5. Devaluation rates varied by specialty. Anesthesiology had a devaluation rate of 83.3%, while neurosurgery had a rate of 77.8%.


 
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    • Editor-in Chief:
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    • Editor:
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      Lin Takahashi
      Thomas Levine
      Cynthia Casteneda Avina
      Ronald Harvinger
      Lisa Andonis

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