Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Business of Medicine/Practice Management

Session: Scientific Oral Presentations - Business of Medicine/Practice Management

2000–2022 Trends in Medicare Utilization and Reimbursement of Tracheostomy

Sunday, September 29, 2024
3:00 PM – 3:06 PM EDT
Location: MBCC, 233
Disclosure(s):
Rahul A. Patel, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Sina J. Torabi, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: With over 5 million adults in the U.S. annually experiencing critical illness, nearly one in 50 undergo tracheostomy. The purpose of this study is to analyze the utilization and reimbursement for tracheostomy in a Medicare population.

Methods: Retrospective analysis of planned tracheostomy (Current Procedural Terminology [CPT] codes 31600, 31601, 31610) and emergency tracheostomy (CPT codes 31603, 31605) procedure utilization and payment using the 2000-2022 Part B National Summary and 2021 Physician and Other Supplier data.

Results: From 2000 to 2022, there was a 48.9% decrease (40,754 to 20,812) in number of planned tracheostomies and a 75.3% decrease (3,277 to 811) in number of emergency tracheostomies, leading to an overall decrease of 51%. Similarly, there was a 59.3% inflation-adjusted decrease ($13.4 million to $5.5 million) in total reimbursement for planned tracheostomies and an 82.1% inflation-adjusted decrease ($1.1 million to $205 thousand) in total reimbursement for emergency tracheostomies. There was a 20.3% inflation-adjusted decrease ($329 to $262) in reimbursement per planned tracheostomy and a 27.7% inflation-adjusted decrease ($349 to $252) in reimbursement per emergency tracheostomy. In our sample of 280 high-volume tracheostomy providers (28.2% otolaryngology, 28.2% general surgery, 14.6% thoracic surgery, 14.3% pulmonary disease, 6.4% critical care), the average provider performed 15.8 tracheostomies on 15.6 patients and was reimbursed $5,362.

Conclusions: Despite significant declines in tracheostomy utilization and reimbursement, understanding trends for these lifesaving procedures is critical for otolaryngologists and other providers in delivering high quality care, and can be used by surgeons, hospital systems, and policymakers to guide future healthcare legislation.

    Presenting Author(s)

  • Rahul A. Patel, MD

    Resident
    Albany Medical Center
    Burlington, NJ, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Sina J. Torabi, MD

    Resident
    University of California, irvine
    Orange, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • SI

    Said Izreig, MD

    Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • R. Peter Peter Manes, MD

    Associate Professor
    Yale School of Medicine
    New Haven, CT, United States

    Disclosure information not submitted.