Development and Structure of BETOS 2.0 with Illustrative Data

Research Report

Development and Structure of BETOS 2.0 with Illustrative Data


The Berenson-Eggers Type of Service (BETOS) classification has been used for 30 years to analyze the physician fee schedule in Medicare and for a range of analytic research purposes. However, over the years, the original BETOS classification became outmoded and required substantial revision. This paper represents a composite of two reports developed for the Medicare Payment Advisory Commission in 2017 and 2019 and describes the reconfiguration of BETOS 1.0 while preserving the basic structure and purposes of the original. Labeled BETOS 2.0, the new classification is currently being reviewed by the Centers for Medicaid & Medicare Services (CMS) for adoption as part of CMS’s desire to expand the BETOS classification to include all Part B services; BETOS 2.0 addresses only physician fee schedule codes. BETOS 2.0, presented here, may be retained as the core of a broader classification, albeit with some marginal changes. This report describes the perceived problems with BETOS 1.0 that developed over time and how BETOS 2.0 addressed them, and it illustrates the greater functionality of 2.0 with analyses of 2017 Medicare Physician Fee Schedule spending. Accompanying the paper is a data file granting users access to the BETOS 2.0 classification code assignments for 2019.

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