Medicare Reimbursement Differentials by Physician Experience

by Richard Buddin, Joyce Mann

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Under current policy, Medicare reimburses for physician services according to a fee schedule that differentiates payment levels for physicians according to their experience. However, experience salaried physicians who have not previously billed for Medicare services are reimbursed as "new" physicians when they first begin treating those covered by Medicare. By examining experience differentials in physician fees and wages in other settings and the reimbursement practices of private insurers, this report provides evidence suggesting that the present Medicare fee schedule is likely to discourage new physicians from treating Medicare patients.

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