How much Medicare pays doctors
For the first time, the government is releasing detailed data about medicare payments to doctors, revealing what procedures doctors performed and what they were paid. The trove of billing records shows that thousands of physicians made more than $1 million each from Medicare in 2012. Dozens billed for more than $10 million. Billing for a large amount is not necessarily a sign of wrongdoing.
Doctors may be unusually efficient, may perform procedures that require high overhead, or may treat an especially large number of Medicare patients. Government inspectors, however, have recommended greater scrutiny for high billers.
Medicare paid doctors $64 billion in 2012. Most of it was for expenses.
Specialties with large percentages of their Medicare payments going to:
These specialties have very high investments in equipment and staff.
|Total paid, in millions||Percentage of total Medicare payments|
|Oral surgery (dentists only)||10||56|
Drugs and other costs
These specialties often have to administer expensive drugs.
These fields have less overhead, so most of the payment goes to the provider.
|Licensed clinical social worker||$83||79%|
|Hospice and palliative care||11||65|
|Critical care (intensivists)||208||62|
|Certified clinical nurse specialist||31||61|
Surgeons pay relatively more toward malpractice.
|Plastic and reconstructive surgery||126||6|
|Procedure (HCPCS code)
||No. of patients
||No. of procedures
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Note: Descriptions of the medical procedures and related codes are from the Current Procedural Terminology (CPT®) code set, which is copyrighted by the American Medical Association.
Source: Department of Health and Human Services Department, Centers for Medicare and Medicaid Services