Physician code creep: evidence in Medicaid and State Employee Health Insurance billing

Health Care Financ Rev. Summer 2007;28(4):83-93.

Abstract

This study estimates a fixed effects ordered logit model physician office visit billing using claims data from South Carolina Medicaid and the State Employees Health Plan. The results find code creep increasing expenditures on physician office visits at a rate of 2.2 percent annually for both programs, with no significant difference in the rate between the two. The models also indicate that physician billing patterns differ between the programs, with the Medicaid claims averaging 1.3 percent less per visit than comparable State Employees Health Plan claims.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Fee-for-Service Plans
  • Female
  • Forms and Records Control / economics*
  • Forms and Records Control / trends
  • Health Benefit Plans, Employee / economics*
  • Humans
  • Insurance Claim Review
  • Male
  • Medicaid / economics*
  • Middle Aged
  • Physicians
  • South Carolina
  • State Government
  • State Health Plans
  • United States