Increasing Utilization of Intratympanic Injections among Medicare Fee-for-Service Providers.

Abstract

Objective: To characterize national practice patterns and geographic variations in intratympanic injections among Medicare providers.

Study design: Retrospective cross-sectional analysis of intratympanic injections performed in the Medicare fee-for-service population from 2013 to 2021.

Setting: Center for Medicare & Medicaid Services Physician and Other Practitioners database.

Participants: Providers performing outpatient intratympanic injections, documented by Current Procedural Terminology code 69801.

Interventions: Intratympanic injections.

Main outcome measures: The number of intratympanic injections performed by individual providers, states, and geographic regions, as well as reimbursements, was analyzed annually.

Results: A total of 159,236 in-office intratympanic injections were performed. The Center for Medicare & Medicaid Services reimbursed $25,407,086; out-of-pocket patient costs were $6,591,514. The mean Medicare reimbursement rate and out-of-pocket cost per injection were $159.56 and $41.38, respectively. From 2013 to 2021, the number of intratympanic injections increased from 13,117 to 20,711 injections, representing a 57.9% increase. On linear regression, an additional 989.9 injections were performed each year (95% CI 766.4-1,213.4, p < 0.001). The number of providers performing injections also increased from 1,828 to 2,834 from 2013 to 2021 ( b = 125.6 [95% CI 111.3-140.0], p < 0.001). The population-controlled annual mean number of injections varied substantially across the United States, ranging from 12.0 injections per 100,000 beneficiaries in Oklahoma to 255.2 injections per 100,000 beneficiaries in Alabama.

Conclusions: The number of intratympanic injections administered in the Medicare population has increased from 2013 to 2021. There is variability in practice patterns and utilization of intratympanic injections among otolaryngologists in the United States.