Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Actinic Keratosis Treatment Burden in Medicare

JAMA Dermatology; ePub 2018 Sep 19; Yeung, et al

Actinic keratosis imposes continuously increasing levels of treatment burden in the Medicare fee-for-service population, according to a recent study. Furthermore, reimbursement decreases have been used to control rising costs of actinic keratosis treatment. A billing claims analysis was performed of the Medicare Part B Physician/Supplier Procedure Summary Master Files and National Summary Data of premalignant skin lesion destructions performed from 2007 to 2015 among Medicare Part B fee-for-service beneficiaries. Researchers found:

  • >35.6 million actinic keratosis lesions were treated in 2015, increasing from 29.7 million in 2007.
  • Treated actinic keratosis lesions per 1,000 beneficiaries increased from 917 in 2007 to 1,051 in 2015, while mean inflation-adjusted payments per 1,000 patients decreased from $11,749 to $10,942 owing to reimbursement cuts.
  • The proportion of actinic keratosis lesions treated by independently billing nurse practitioners and physician assistants increased from 4.0% in 2007 to 13.5% in 2015.


Yeung H, Baranowski ML, Swerlick RA, et al. Use and cost of actinic keratosis destruction in the Medicare Part B fee-for-service population, 2007 to 2015. [Published online ahead of print September 19, 2018]. JAMA Dermatology. doi:10.1001/jamadermatol.2018.3086.

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