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Jan 04: "Growth of Services, Charges and Payments"
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EM Coding Trend Analysis:
"Average Charges Paid by Medicare"
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Using the top five CPT® codes charged to Medicare between 1999 and 2002, we calculated the
average percentage paid by Medicare for services charged (Charges Paid/Total Services) and
graphed the results. You can see by the chart below that in general, the percentage
of Charges Paid improved over the five year period. However, approximately 30% of Charges
submitted were not Paid by Medicare.
The year 2000 showed the highest increase in Charges Paid, while 2002 showed only a very small
percentage increase. Over the five year period, CPT codes 99211 and 99214 had the best Payment
percentage out of the Top 5, and CPT 99213 had the lowest payment percentage, although it
should be noted that in general all five top CPTs maintained very similar payment percentages.
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Data Source: CMS Utilization Data, 1998 through 2002
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