An Analysis of Current Treatment Trends in Platelet-Rich Plasma Therapy in the Medicare Database.
Level 4 - case-series / case-control
Descriptive administrative database study without a comparator group
PubMed 32083143 · doi:10.1177/2325967119900811
What was done
Descriptive epidemiological analysis of the Medicare Standard Analytical Files within the PearlDiver database from 2010 to 2014. Investigators queried Current Procedural Terminology code 0232T to identify platelet-rich plasma injections, categorizing them by anatomical region (shoulder, knee, elbow, hip, foot/ankle), operative versus nonoperative setting, patient demographics, geographic distribution, and Medicare charges.
What was found
A total of 3,654 PRP injections were identified. Recipients were 57% male and 33% were aged 65 to 69 years. The southern region accounted for 42% of all injections. PRP was most frequently used for shoulder diagnoses (majority administered at the time of surgery), followed by foot/ankle and knee diagnoses (majority administered nonoperatively). Annual Medicare charges for PRP injections increased 400%, from $500,000 in 2010 to more than $2 million in 2014.
Why it matters
Documents a steep increase in PRP utilization and associated billing in the Medicare population despite variable coverage policies and limited consensus guidelines.
Limits
Relies on administrative billing data subject to coding errors and uncaptured cash-pay procedures. Clinical efficacy, preparation methods, injection composition, and patient outcomes were not evaluated. Data are from 2010 to 2014 and may not reflect current utilization.
Cited by
- context Most regenerative injection therapies do not have specific CPT billing codes.