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A profile of neurology practice based on Medicare services

An AAN Medical Economics and Management Committee Report

From the University of California Los Angeles (Dr. Nuwer); American Academy of Neurology (M. Duncan), Center for Health Policy, St. Paul, MN; and Stanford University (J.M. Nuwer), Palo Alto, CA.

Address correspondence and reprint requests to Dr. Marc R. Nuwer, UCLA Department of Neurology, 710 Westwood Plaza, Los Angeles, CA 90095; e-mail: mrn{at}ucla.edu

OBJECTIVE: This report uses Medicare data to provide insight into the patient care services most often provided by neurologists.

METHODS: The 1998 Medicare data set for physician services was obtained from the Health Care Financing Administration. Neurologists’ services were tabulated and compared to the 1998 American Academy of Neurology Member Demographic and Practice Characteristics Report. A profile was derived of neurologists’ typical services.

RESULTS: Patient visits represent 70% of neurologists’ services when evaluated by income. Office was the site of service for 62% of patient visit income. Established patients were 29% of patient visit income. Neurologists frequently code patient visits at levels of service higher than used by other physicians. EMG and nerve conduction velocity together represent 55% of neurodiagnostic services when evaluated by income.

CONCLUSIONS: Patient care continues to be the main service of neurologists, with office care more than hospital care. Established patient care is an important part of patient services, confirming the role of the neurologist in principal care. Neurologists’ patient care levels of service are higher than for other physicians.