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Reimbursement

Steady increase in Medicare Reimbursement

Since 2009, the RFA procedure has seen a significant Medicare reimbursement increase. In the past 5 years, Medicare reimbursement rates have risen $521 for a 2014 reimbursement of $3,327 per procedure. Other sleep medicine procedures, such as uvulopalatopharyngoplasty have similar success rates however Medicare reimbursement rates have only risen $86 in the same time period.

Reimbursement

Formula for Success

We can look at the following example for the formula for success. Each SATCOA location treats 72 patients per year, with each individual receiving on average 6 RFA treatments over the course of 6 months. By the sixth month, most of our patients will have achieved the maximum amount of volumetric reduction of their tongue base. On average, these 72 patients will have generated 432 procedures at an average Medicare allowable of $3,200 per treatment. After performing thousands of procedures our physicians have been able to perform the procedure in approximately 2-5 minutes, while keeping infection rates less to than 1% compared to a 4% industry average.

Reimbursement

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