Gastroenterologists are no strangers to reimbursement difficulties, but as new procedures arise so do coverage disputes.
Vivek Kaul, MD, Segal-Watson professor of medicine in the gastroenterology and hepatology division at the University of Rochester (N.Y.) Medical Center, recently connected with Becker's to discuss the biggest challenge gastroenterologists face regarding reimbursement rates for GI procedures.
Note: This response has been lightly edited for length and clarity.
Dr. Vivek Kaul: There is the well known issue of decreasing reimbursement over time for procedures that already have existing CPT codes, and that too in the face of the post-pandemic increased demand, higher costs of doing business and staffing issues. In addition, a real challenge we are facing is the inability to get reimbursed for a host of relatively newer (but well established) endoscopic procedures that have emerged in the last decade or so. Oftentimes, these are minimally invasive, transformational interventions for our patients that help reduce morbidity, length of stay and overall healthcare costs but are poorly reimbursed or not reimbursed at all, in some cases.