COVID-19 tests drove an increase in total Medicare Part B spending on lab tests in 2020, while use of non-COVID-19 tests decreased significantly
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Data brief (United States. Department of Health and Human Services. Office of Inspector General)
- Contributor(s):
- United States. Department of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections, issuing body.
- Publication:
- Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, December 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Clinical Laboratory Techniques -- economics COVID-19 Testing -- economics Government Regulation Medicare Part B -- economics United States United States. Department of Health and Human Services
- Genre(s):
- Technical Report
- Abstract:
- Medicare Part B spending on clinical diagnostic laboratory (lab) tests in 2020 was affected by significant new spending on COVID-19 tests, a type of test that did not exist before the pandemic. Overall spending increased from $7.7 billion in 2019 to $8.0 billion in 2020. This increase in spending was driven by $1.5 billion in new spending on COVID-19 tests, including $1.0 billion on a rapid COVID-19 test procedure code, which was the number 1 test by spending. Aside from COVID-19 tests, spending for all other tests, as a group, decreased by about $1.2 billion in 2020. The decline in spending was driven by a sharp decline in non-COVID-19 tests during the early months of the pandemic, as well as further reductions in payment rates for some of these tests, as required by the Protecting Access to Medicare Act of 2014 (PAMA). Why OIG Did This Review. PAMA changed the way the Medicare program sets payment rates for lab tests by aligning Medicare payment rates with private payment rates. The Centers for Medicare & Medicaid Services (CMS) calculated new rates that took effect in 2018. As part of PAMA, Congress also mandated that the Office of Inspector General (OIG) publicly release an annual analysis of the top 25 tests based on Medicare spending and conduct analyses that OIG determines appropriate. This data brief provides an analysis of Medicare payments for lab tests in 2020.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (15 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918383984506676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918383984506676