COSTS OF DUPLEX SCANNING AND THE IMPACT OF THE CHANGES IN MEDICARE REIMBURSEMENT

Purpose: To obtain objective cost data to use in a formal comment on the proposed changes in Medicare reimbursement, a mail survey of vascular laboratories was carried out. Methods: Data were received from 142 facilities. Patients receiving Medicare made up 64% of the volume, and duplex scanning accounted for 78% of the work. Results: The mean cost per scan, exclusive of physician payments, was $181. When compared with the mean allowable reimbursement under the 1992 Fee Schedule of $113, this represents a loss of $68 for each duplex scan performed on a patient receiving Medicare. In general, there was tittle difference in costs when the data were analyzed on the basis of type or size of facility. For laboratories providing data on 1991 Medicare reimbursements, the new fee schedule results in a 38% drop in payments. Conclusions: These data substantiate the impression that the Health Care Finance Administration has substantially undervalued the costs of performing duplex scanning.