Anorectal Manometry and Colonoscopy Reimbursement Trends 2006-2016

Posted by Clark Love on Feb 9, 2016 10:49:26 AM
 

I recently attended a statewide gastroenterology conference in Mississippi. I got to meet all types of interesting people, including accomplished doctors and their staffs. For this conference I compiled some data on anorectal manometry (ARM) reimbursement rates.  Given gastroenterologist use of colonoscopies, I thought it would be useful to compare ARM reimbursements (CPT Codes 91120, 91122, and 51784) to screening colonoscopy reimbursements (CPT Code 45378).   I was aware that ARM reimbursed at a better rate, but I was not aware it was substantially better.  When looking only at National Medicare reimbursements, anorectal manometry reimburses at a 93% higher rate than a screening colonoscopy.  In the chart below you'll see the trend of reimbursements rates both nationally and within the state of Mississippi over the last decade. As you can see, and as every gastroenterologist knows, colonoscopy reimbursement rates have fallen quite significantly and are expected to fall more in coming years. However, ARM shows a more stable reimbursement rate, especially in recent years.

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Topics: Reimbursement, Anorectal Manometry, Colonoscopy, colonoscopies, Reimbursement Trends

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