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The 10 Specialties with the Highest Medicare Part B Payments

Article

A new data set from the Centers for Medicare and Medicaid Services shows the agency paid about $90 billion to 950,000 providers for Medicare Part B Fee-For-Service patients in 2013. These 10 provider types had the highest average payments, on a per-provider basis.

Medicare costs

The Centers for Medicare and Medicaid Services on Monday released a new set of data describing how much the agency paid out under the Medical Part B Fee-for-Service system in 2013. The information covers 950,000 distinct healthcare providers in all 50 states. In total, it shows they collected $90 billion in Medicare payments that year.

On a macro level, the data tell an important story about the overall cost of healthcare in the US. However, when the data are broken down, the numbers begin to paint a picture about the relative cost of treatment in various clinical specialties.

What follows is a list of the 10 specialties with the highest average per-provider payments in 2013. The list is ranked by allowed payments for medical services. Each data capsule also includes the number of providers Medicare paid, the average number of unique medical services per provider in the specialty, and the average payment per provider for drug services.

A few notes: The data are based on average allowed payments, and some data were excluded. For instance, services provided to 10 or fewer beneficiaries were not included. The data only cover those in the fee-for-service program of Medicare Part B, and thus does not reflect the payments and costs of patients with other forms of coverage. The agency noted that costs can also vary geographically, as CMS uses a cost-of-living adjustment. The drug services payments, which cover cases where providers purchase a drug and administer it to a patient, are paid at a rate of 106% of the average sale price for the drug administered.

Hematology

Average Payment per Provider for Medical Services: $128,187

Number of Providers: 660

Average Number of Unique Types of Services: 24

Average Payment per Provider for Drug Services: $265,011

Rheumatology

Average Payment per Provider: $156,839

Number of Providers: 3,769

Average Number of Unique Types of Services: 34

Average Payment per Provider for Drug Services: $298,011

Medical Oncology

Average Payment per Provider: $181,747

Number of Providers: 2,593

Average Number of Unique Types of Services: 32

Average Payment per Provider for Drug Services: $473,926

Hematology/Oncology

Average Payment per Provider: $225,679

Number of Providers: 7,070

Average Number of Unique Types of Services: 37

Average Payment per Provider for Drug Services: $583,237

Cardiology

Average Payment per Provider: $296,129

Number of Providers: 19,650

Average Number of Unique Types of Services: 53

Average Payment per Provider for Drug Services: $7,062

Interventional Pain Management

Average Payment per Provider: $313,547

Number of Providers: 1,664

Average Number of Unique Types of Services: 48

Average Payment per Provider for Drug Services: $8,335

Ophthalmology

Average Payment per Provider: $326,621

Number of Providers: 14,473

Average Number of Unique Types of Services: 32

Average Payment per Provider for Drug Services: $166,745

Vascular Surgery

Average Payment per Provider: $329,874

Number of Providers: 2,665

Average Number of Unique Types of Services: 48

Average Payment per Provider for Drug Services: $206

Dermatology

Average Payment per Provider: $331,108

Number of Providers: 7,492

Average Number of Unique Types of Services: 53

Average Payment per Provider for Drug Services: $2,937

Radiation Oncology

Average Payment per Provider: $403,512

Number of Providers: 3,912

Average Number of Unique Types of Services: 34

Average Payment per Provider for Drug Services: $4,687

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