The Diversion of Outpatient Echocardiography From Private Offices to Higher Cost Hospital Facilities: An Unanticipated Effect of Code Bundling

Echocardiography code bundling produced the expected sharp drop in outpatient claims from cardiologists in 2009. But after bundling, office echocardiography rates continued to drop, while HOPD rates increased. It seems that in this instance, code bundling led to the closure of many cardiology offices and a resultant shift of echocardiography from that lower cost setting to the higher cost HOPD setting.