Disparities in Gynecologic Oncology: Descriptive Study of Changes in Medicare Reimbursement Rates in the United States [ID 953]

INTRODUCTION: Medicare reimbursement for gynecologic oncology services and procedures is declining across the United States. The current study examines the most common billing codes in gynecologic oncology, quantifying annual changes in Medicare reimbursement and identifying geographic variance in reimbursement from 2013 to 2021. METHODS: The Centers for Medicare and Medicaid Services database for Medicare Physician and Other Practitioners by Geography and Service was used to assess reimbursement for gynecologic oncology billing codes. Twenty-four codes were selected from the Healthcare Common Procedure Coding System. Percent reimbursement for these codes was analyzed by region, state, and cancer type. RESULTS: Medicare reimbursement for gynecologic oncology services and procedures significantly declined in all 50 states from 2013 to 2021 ( P <.001). Our study shows reimbursement patterns vary according to geographic region. Medicare reimbursement from greatest to least by region was Southern, Western, Midwest, and Northeast. The largest declines in reimbursement by state were Wyoming, Utah, and North Dakota. The smallest decline in reimbursement was found in Tennessee. Significant differences in reimbursement were found for codes related to specific gynecologic cancers ( P <.001). Medicare reimbursement from greatest to least by cancer type was cervical, uterine, and ovarian cancer. CONCLUSIONS/IMPLICATIONS: Medicare reimbursement for gynecologic oncology services and procedures declined from 2013 to 2021. Regional differences and the overall decline in physician payments create financial incentives for physicians to practice in higher reimbursement areas, which may contribute to health care disparities in gynecologic oncology.