Does the reimbursement of anesthesiologists for intraoperative transesophageal echocardiography promote increased utilization?

Objective: To determine whether access to reimbursement increases anesthesiologists' use of intraoperative transesophageal echocardiography (TEE). Design: Survey. Setting: United States. Participants: Members of the Society of Cardiovascular Anesthesiologists, local Medicare carriers. Interventions: None. Measurements and Main Results: In year 2000, local Medicare carrier policies specifically allowed some form of reimbursement to the attending anesthesiologist for intraoperative TEE in 15 states, but barred all forms of reimbursement in 16 states and Puerto Rico. Data regarding utilization and billing were available for 702 members of the Society of Cardiovascular Anesthesiologists from these jurisdictions who used TEE in their anesthetic practice. Billing patterns were found to vary significantly according to the local Medicare policy in effect (p = 0.004). Use of intraoperative TEE was found to be unrelated, however, to the reimbursement available from Medicare (p = 0.2 to 0.7). Conclusion: The use of intraoperative TEE by anesthesiologists does not seem to be related to the availability of reimbursement from Medicare. Copyright 2002, Elsevier Science (USA). All rights reserved.