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To the Editor: In their Research Letter, Dr Landers and colleagues¹ discuss possible explanations for trends in house calls to Medicare beneficiaries. It is unlikely that the 1998 Medicare increase in reimbursement for home visits was responsible for the increased number of physician house calls made between 1998 and 2004.

The authors referenced the 2004 allowed charge for a comprehensive home visit to an established patient (99350), when most home visits made to Medicare beneficiaries by physicians are extended (99349) or intermediate (99348) visits.² Between 1998 and 2004, the Medicare reimbursement for an extended home visit was 68% of the amount paid for a comprehensive visit, while the reimbursement for an intermediate visit was 44% of that amount.³

Additionally, Medicare reimbursement for home visits does not take into consideration potential revenues lost while a physician is away from the office, travel expenses to and from patients' homes, or the amount . . . [Full Text of this Article]

Bernard Leo Remakus, MD
remakus@epix.net
Family and Community Medicine
Temple University School of Medicine
Hallstead, Pa

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