There is a difference between in- and outpatient reimbursement for FEESST. Because we were studying hospitalized patients, we used only inpatient reimbursement data for our analysis.
The protocols for MBS and FEESST have been described in detail elsewhere.
Charging on the basis of the three FEESST CPT codes (31575, 92520-59, and 92525) plus the initial consult code resulted in a mean reimbursement of $230.84 plus $91.85, for a total of $322.69.
The average total reimbursement for FEESST was significantly lower than that for MBS (p[less than]0.0001, Mann-Whitney U test).
In summary, Medicare reimbursement for the initial inpatient FEESST was 28% less than that for MBS ($322.69 vs $451.01); put another way, MBS generated 40% more reimbursement than did initial inpatient FEES ST.
The cost-effectiveness of FEESST compared with MBS in the diagnosis and management of dysphagia in patients with head and neck cancer can be more fully appreciated if one extrapolates the expected savings we found to the nation as a whole.
The advantages of FEESST over MBS extend to areas beyond direct reimbursement.