TOPLINE:

Superficial radiation therapy (SRT) cost considerably more than Mohs micrographic surgery (MMS) for nonmelanoma skin cancer treatment, according to a Medicare data analysis.

METHODOLOGY:

• Researchers queried Medicare provider and service data from 2018 to 2022 for dermatology billing claims related to SRT.
• They analyzed current procedural terminology (CPT) codes for radiation delivery, simulation complexity, and ultrasound guidance and used Medicare Physician Fee Schedule payments to estimate costs.
• Researchers also evaluated the frequency of SRT, the number of dermatology clinicians providing services, and total Medicare expenditure across the study period.

TAKEAWAY:

• In 2022, costs of image-guided SRT were 217% (12 fractions), 428% (20 fractions), and 559% (25 fractions) higher than a representative MMS case with complex closure.
• The use of image guidance increased by 250% over the study period along with a 37.5% rise in the number of dermatologists performing SRT.
• Simple radiation simulations increased by 123% in frequency from 2018 to 2022, with simple simulations billed at 90% of SRT sessions in 2022 vs 51% in 2018.
• The total Medicare expenditure increased by 1087.1%, from $2,027,844 to $24,073,335.

IN PRACTICE:

“SRT may have a role in treating select patients, particularly those who are poor surgical candidates due to morbidity, advanced age, or patient refusal,” the authors wrote. Regardless, they noted that “SRT, especially [image-guided] SRT, is a higher-cost option compared to MMS.”

SOURCE:

The study was led by Jeremy G. Light, MD, Division of Dermatology, Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, and was published online as a brief report on March 24 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

Costs tied to specified CPT codes were evaluated, but additional expenses, such as facility fees, were omitted. The study did not assess subjective outcomes, including patient experience.

DISCLOSURES:

The study did not receive any specific funding, and the authors declared having no relevant conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.