title: Radiation oncology services in the modern era: evolving patterns of usage and payments in the office setting for medicare patients from 2000 to 2010.
abstract: OBJECTIVE
  We evaluated long-term changes in the volume and payments for radiation oncology services in the intensity-modulated radiation therapy (IMRT) era from 2000 to 2010 using a database of Medicare claims.
  
  
  METHODS
  We used the Medicare Physician/Supplier Procedure Summary Master File (PSPSMF) for each year from 2000 to 2010 to tabulate the volume and payments for radiation oncology services. This database provides a summary of each billing code submitted to Medicare part B. We identified all codes used in radiation oncology services and categorized billing codes by treatment modality and place of service.
  
  
  RESULTS
  We focused our analysis on office-based practices. Total office-based patient volume increased 8.2% from 2000 to 2010, whereas total payments increased 217%. Increase in overall payments increased dramatically from 2000 to 2007, but subsequently plateaued from 2008 to 2010. Increases in complexity of care, and image guidance in particular, have also resulted in higher payments.
  
  
  CONCLUSIONS
  The cost of radiation oncology services increased from 2000 to 2010, mostly due to IMRT, but also with significant contribution from increased overall complexity of care. A cost adjustment occurred after 2007, limiting further growth of payments. Future health policy studies should explore the potential for further cost containment, including differences in use between freestanding and hospital outpatient facilities.
authors.affiliation: University of Kansas Medical Center, Kansas City, KS; Thomas Jefferson University, Philadelphia, PA; and University of Maryland, Baltimore, MD xshen@kumc.edu.
authors.forename: Xinglei
authors.initials: X
authors.lastname: Shen
authors.affiliation: University of Kansas Medical Center, Kansas City, KS; Thomas Jefferson University, Philadelphia, PA; and University of Maryland, Baltimore, MD.
authors.forename: Timothy N
authors.initials: TN
authors.lastname: Showalter
authors.affiliation: University of Kansas Medical Center, Kansas City, KS; Thomas Jefferson University, Philadelphia, PA; and University of Maryland, Baltimore, MD.
authors.forename: Mark V
authors.initials: MV
authors.lastname: Mishra
authors.affiliation: University of Kansas Medical Center, Kansas City, KS; Thomas Jefferson University, Philadelphia, PA; and University of Maryland, Baltimore, MD.
authors.forename: Sanford
authors.initials: S
authors.lastname: Barth
authors.affiliation: University of Kansas Medical Center, Kansas City, KS; Thomas Jefferson University, Philadelphia, PA; and University of Maryland, Baltimore, MD.
authors.forename: Vijay
authors.initials: V
authors.lastname: Rao
authors.affiliation: University of Kansas Medical Center, Kansas City, KS; Thomas Jefferson University, Philadelphia, PA; and University of Maryland, Baltimore, MD.
authors.forename: David
authors.initials: D
authors.lastname: Levin
authors.affiliation: University of Kansas Medical Center, Kansas City, KS; Thomas Jefferson University, Philadelphia, PA; and University of Maryland, Baltimore, MD.
authors.forename: Laurence
authors.initials: L
authors.lastname: Parker
mesh_terms: D018588:Fee-for-Service Plans; D017048:Health Care Costs / Q000639:trends; D049674:History, 21st Century; D006801:Humans; D006278:Medicare / Q000191:economics / Q000639:trends*; D018787:Radiation Oncology / Q000191:economics / Q000458:organization & administration / Q000639:trends*; D014481:United States