Work

Plugging gaps in payment systems: Evidence from the take‐up of new Medicare billing codes

Year: 2025

Type: article

Abstract: We analyze the introduction of new Medicare billing codes for Chronic Care Management (CCM) and Transitional Care Management (TCM). We first show that new code take‐up occurs gradually and varies across space and physician characteristics. Second, we study how the codes correlate with other services, focusing on two case studies. Illustrating code substitution, we show TCM services predict fewer traditional office visits following hospital discharges, suggesting crowd out. Illustrating code complementarity, we show TCM and CCM services predict increases in annual wellness visits. Take‐up frictions and the relationship between new and existing codes are important for evaluating payment reforms.

Source: Contemporary Economic Policy

DOI: 10.1111/coep.12696

Authors: Jeffrey Clemens, Jonathan M. Leganza, Alex Masucci

Institutions: University of California San Diego, Clemson University

Language: English

Topic: Healthcare Policy and Management

Subfield: Economics and Econometrics

Field: Economics, Econometrics and Finance

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $2,970