Doctors & Other Professionals Billing Medicare At Higher Rates

Fred Schulte, Joe Eaton and David Donald | The Washington Post | September 15, 2012

Thousands of doctors and other medical professionals have billed Medicare for increasingly complicated and costly treatments over the past decade, adding $11 billion or more to their fees — and signaling a possible rise in medical billing abuse, according to an investigation by the Center for Public Integrity.

Between 2001 and 2010, doctors increasingly moved to higher-paying codes for billing Medicare for office visits while cutting back on lower-paying ones, according to a year-long examination of about 362 million claims. In 2001, the two highest codes were listed on about 25 percent of the doctor-visit claims; in 2010, they were on 40 percent.

Similarly, hospitals sharply stepped up the use of the highest codes for emergency room visits while cutting back on the lowest codes.