Senior author Christina Downey, MD, a rheumatologist at Loma Linda University School of Medicine, also notes that the evaluation and management codes tend to undervalue the revenue generated by a rheumatologist. Example: She says that after adjusting for inflation, Medicare reimbursement for the evaluation and management code 99214, which is used for care requiring moderate complexity medical decision making or a total of 30–39 minutes devoted to the encounter on the date of the visit, has remained stagnant from 2005 to 2020. This finding is true despite the increase of indirect overhead costs, such as hospital administrative, financial and legal operations.
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The authors hope their study will aid individuals in positions of leadership in academic health systems use the overall value rheumatologists bring to the health system as an argument for higher compensation or more protected time for clinical academic rheumatologists.
“What we are trying to do with this paper is to arm practicing rheumatologists with the knowledge of the value that they bring,” says Dr. Downey, noting that rheumatologists are cognitive specialists who, unlike orthopedic surgeons, cannot rely on high volume procedures.
In their article, the authors note that interventional cardiologists are well compensated due, in part, to the revenue brought to the hospital system from their procedures, and they argue the same consideration should be given to rheumatologists.
Lara C. Pullen, PhD, is a medical writer based in the Chicago area.
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- Romao VC, Fonseca JE. Major challenges in rheumatology: Will we ever treater smarter, instead of just harder? Front Med (Lausanne). 2019 Jun 26;6:144.
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