Chronic back pain has a significant health burden in the United States, affecting over 80% of the population at some point in their lives. In this study, we analyze Medicare data from 2000 to 2020 to identify trends in procedural utilization and reimbursement rates for the most common back pain procedures. Understanding these trends can help inform healthcare policies and practices to improve the quality and cost-effectiveness of care for individuals with chronic back pain.
A query of the Medicare Part B Data from 2000 to 2020 was conducted. The data contained information regarding services billed to Medicare for each Current Procedural Terminology (CPT) code for the given year. This included annual total physician charges, reimbursements and the number of procedures conducted. The allowed charges and payments were divided by the total allowed services to calculate the allowed and actual charges per code.
The number of pain procedures rose from 2000 to 2020, with the most common being lumbar/sacral epidural injections. Percutaneous SCS had the greatest volume growth, increasing by [+2992%]. All procedures saw an increase, except for facet joint injections. Inflation-adjusted per service also increased, with the largest jump at [+379.0%] for SCS (Open).open) increases highest at +379%, SCS (percutaneous) at +304.5%, and cervical/thoracic epidurals at +19.5%. Facet joint injections saw no volume increase.
The past two decades have seen a dramatic increase in the use and reimbursement of alternative pain management procedures. This increased support has led to more patients gaining access to these treatments, allowing the chronic pain sufferer to explore various alternatives to traditional medication and invasive techniques.