Medicare Trends in Pathologist Participation, Service Utilization, and Payments

Simone Arvisais-Anhalt, Ellen Araj, Jason Y. Park

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Quantifying pathologist participation in Medicare services may be informative for the prediction of future workforce needs and reimbursement. Methods: A retrospective examination was performed of pathologist professional (Part B) Medicare billings and payments from 2012 to 2017. The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File was the primary data source. Results: From 2012 to 2017, there was an increase (3.7%; 11,215 up to 11,627) in pathologists providing Medicare Part B services. Female pathologists increased from 36.10% to 40.8% of pathologists during this time period. Normalized per pathologist, there was an increase (7.8%; 1,382 up to 1,489) in beneficiaries served as well as an increase (4.1%; 2,442 up to 2,543) in services performed. The top 10 pathology Part B services performed in a facility were all surgical pathology. Although services increased, the overall payment of Part B pathology services decreased (3%; $996,519,358 down to $966,615,856) during the study period. Conclusions: Although there is increasing pathologist participation in Medicare, the workload per pathologist has increased.

Original languageEnglish (US)
Pages (from-to)674-679
Number of pages6
JournalAmerican journal of clinical pathology
Volume155
Issue number5
DOIs
StatePublished - May 1 2021

Keywords

  • Billing
  • Medicare
  • POSPUF
  • Part B
  • Pathology workforce
  • Payment

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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