title: How neurologists are paid: Part 1: The Medicare payment system.
abstract: Neurologists are facing yearly reductions in reimbursement for rendered services. These reductions arise from changes by Medicare, Medicaid, and third-party payers to achieve cost savings. In Part 1, we discuss reimbursement for office visits and procedures, the relative value scale, the conversion factor used by Medicare to transform work into payments, and the recently repealed sustainable growth rate. The establishment of new codes for transitional care and chronic care management may augment the salaries of neurologists who care for patients with chronic conditions. Medicare's recent elimination of payment for consultations and the bundling of nerve conduction studies have dramatically affected reimbursement. Large discrepancies remain between compensation for procedures and office visits.
authors.affiliation: Vanderbilt University Medical Center (PDD), Nashville, TN; Henry Ford Hospital (GLB), Detroit, MI; Children's Hospital Medical Center of Akron (BHC), OH; Texas Neurology (DAE), Dallas; Emory University (GJE), Atlanta, GA; University of Maryland (BS), School of Medicine, Baltimore; University of Calgary (JRB), Alberta Children's Hospital, Canada; and American Academy of Neurology (AB), Minneapolis, MN.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Donofrio
authors.affiliation: Vanderbilt University Medical Center (PDD), Nashville, TN; Henry Ford Hospital (GLB), Detroit, MI; Children's Hospital Medical Center of Akron (BHC), OH; Texas Neurology (DAE), Dallas; Emory University (GJE), Atlanta, GA; University of Maryland (BS), School of Medicine, Baltimore; University of Calgary (JRB), Alberta Children's Hospital, Canada; and American Academy of Neurology (AB), Minneapolis, MN.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Barkley
authors.affiliation: Vanderbilt University Medical Center (PDD), Nashville, TN; Henry Ford Hospital (GLB), Detroit, MI; Children's Hospital Medical Center of Akron (BHC), OH; Texas Neurology (DAE), Dallas; Emory University (GJE), Atlanta, GA; University of Maryland (BS), School of Medicine, Baltimore; University of Calgary (JRB), Alberta Children's Hospital, Canada; and American Academy of Neurology (AB), Minneapolis, MN.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Cohen
authors.affiliation: Vanderbilt University Medical Center (PDD), Nashville, TN; Henry Ford Hospital (GLB), Detroit, MI; Children's Hospital Medical Center of Akron (BHC), OH; Texas Neurology (DAE), Dallas; Emory University (GJE), Atlanta, GA; University of Maryland (BS), School of Medicine, Baltimore; University of Calgary (JRB), Alberta Children's Hospital, Canada; and American Academy of Neurology (AB), Minneapolis, MN.
authors.forename: David A
authors.initials: DA
authors.lastname: Evans
authors.affiliation: Vanderbilt University Medical Center (PDD), Nashville, TN; Henry Ford Hospital (GLB), Detroit, MI; Children's Hospital Medical Center of Akron (BHC), OH; Texas Neurology (DAE), Dallas; Emory University (GJE), Atlanta, GA; University of Maryland (BS), School of Medicine, Baltimore; University of Calgary (JRB), Alberta Children's Hospital, Canada; and American Academy of Neurology (AB), Minneapolis, MN.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Esper
authors.affiliation: Vanderbilt University Medical Center (PDD), Nashville, TN; Henry Ford Hospital (GLB), Detroit, MI; Children's Hospital Medical Center of Akron (BHC), OH; Texas Neurology (DAE), Dallas; Emory University (GJE), Atlanta, GA; University of Maryland (BS), School of Medicine, Baltimore; University of Calgary (JRB), Alberta Children's Hospital, Canada; and American Academy of Neurology (AB), Minneapolis, MN.
authors.forename: Bryan
authors.initials: B
authors.lastname: Soronson
authors.affiliation: Vanderbilt University Medical Center (PDD), Nashville, TN; Henry Ford Hospital (GLB), Detroit, MI; Children's Hospital Medical Center of Akron (BHC), OH; Texas Neurology (DAE), Dallas; Emory University (GJE), Atlanta, GA; University of Maryland (BS), School of Medicine, Baltimore; University of Calgary (JRB), Alberta Children's Hospital, Canada; and American Academy of Neurology (AB), Minneapolis, MN.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Buchhalter
authors.affiliation: Vanderbilt University Medical Center (PDD), Nashville, TN; Henry Ford Hospital (GLB), Detroit, MI; Children's Hospital Medical Center of Akron (BHC), OH; Texas Neurology (DAE), Dallas; Emory University (GJE), Atlanta, GA; University of Maryland (BS), School of Medicine, Baltimore; University of Calgary (JRB), Alberta Children's Hospital, Canada; and American Academy of Neurology (AB), Minneapolis, MN.
authors.forename: Amanda
authors.initials: A
authors.lastname: Becker