Medicare Trends in Pathologist Participation, Service Utilization, and Payments

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.

Keywords: Billing; Medicare; POSPUF; Part B; Pathology workforce; Payment.