Athletic Trainers as Outpatient Rehabilitation Providers: An Analysis of Role, Value, and Insurance Reimbursement in a Large Academic Healthcare System
Athletic trainers (ATs) are healthcare professionals who provide care across multiple settings, including outpatient rehabilitation. Given the increase in healthcare utilization in the general population, ATs may provide necessary rehabilitation services to treat common musculoskeletal conditions. Describe patient populations, conditions, healthcare utilization, and billing practices of ATs practicing in an outpatient orthopedic setting from January 2010 to December 2024. Retrospective Cohort Study University-based healthcare system. Patients in outpatient orthopedic rehabilitation. Episode of Care (EOC) data were extracted from health insurance claims. Median and interquartile range (IQR) were reported for patient age, number of visits per EOC, Current Procedural Terminology (CPT) codes billed, and charges per visit. Diagnoses associated with the EOC were by taxonomy, nature of injury, and body region categories using International Classification of Disease (ICD) version 9/10 codes. Frequencies, proportions and 95% confidence intervals (95%CI) were reported for taxonomy, nature of injury, body region, and surgical cases. ATs were primary providers for 7,789 EOCs. Median patient age was 37 years [IQR: 19, 51] with the majority of patients being female (4,189; 54%, 95%CI: 53%-55%). The knee and shoulder were the most common body regions treated (knee: 2,993, 26%, (95%CI: 25%, 27%); shoulder: 1,863, 16%, (95%CI: 15%-17%)]. 17% of EOCs indicated presence of a surgical procedure. EOCs comprised a median number of 3 visits [IQR: 2, 6] with 6 median CPT codes [IQR: 2,6] billed, resulting in median EOC charges of $1,291 [IQR: $782, $2,099]. EOCs that were isolated to the inclusion of AT billable procedural codes resulted in $13.5 million in charges and $10.8 million in reimbursements over 15 years. ATs provided primary rehabilitative care to common musculoskeletal conditions particularly of the knee and shoulder. Similar billing practices as other allied health professionals were observed based on CPT codes billed and median charges per visitABSTRACT
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Contributor Notes
Mr. Joseph Greene, MS, ATC joegreene@orthovise.com
Dr. David R Bell, PhD drbell2@wisc.edu
Dr. Stephanie Kliethermes, PhD Kliethermes@ortho.wisc.edu
Dr. Jacob Naylor, PT, DPT, OCS, CSCS naylorja@unc.edu
Dr. Kristen Kucera, PhD, MSPH, ATC kkucera@email.unc.edu