The Underuse of Medicare's Prevention and Coordination Codes in Primary Care : A Cross-Sectional and Modeling Study.

ABSTRACT:

Background

Efforts to better support primary care include the addition of primary care-focused billing codes to the Medicare Physician Fee Schedule (MPFS).

Objective

To examine potential and actual use by primary care physicians (PCPs) of the prevention and coordination codes that have been added to the MPFS.

Design

Cross-sectional and modeling study.

Setting

Nationally representative claims and survey data.

Participants

Medicare patients.

Measurements

Frequency of use and estimated Medicare revenue involving 34 billing codes representing prevention and coordination services for which PCPs could but do not necessarily bill.

Results

Eligibility among Medicare patients for each service ranged from 8.8% to 100%. Among eligible patients, the me

SUBMITTER: Agarwal SD 

PROVIDER: S-EPMC9933078 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature