224 Physical therapy utilization among WTC Health Program members with cancer

Abstract

Objectives/Goals: Physical therapy (PT) is a recognized and evidence-based component of oncology care that has been shown to benefit people with various cancers, such as breast, lung, head and neck, thyroid, or prostate cancer. The goal of this evaluation was to determine the level of PT service utilization by World Trade Center (WTC) Health Program members with cancer. Methods/Study Population: The Program is a limited benefits federal program that serves responders and survivors of the September 11th attacks in New York City, the Pentagon, and Shanksville PA. Our analyses include enrolled Program members with a cancer certification. Cancer types were divided into two categories, Category A (breast, lung, head and neck, thyroid, or prostate cancer) and Non-Category A (all other cancer types). Data included medical claims, certification, and enrollment data from July 2011 to December 2023. The 2023 Current Procedural Terminology (CPT) code list from the Centers for Medicare and Medicaid Services were used to identify claims associated with PT interventions. Our analyses describe trends in PT claims, CPT codes, cancer certifications by subtype, and number of members with Category A cancers and PT claims. Results/Anticipated Results: Since the Program’s inception in 2011, PT claims had gradually increased except for in 2020 when there was a sudden decrease, most likely due to the interruption of in-person services due to the COVID-19 pandemic. From 2021 to 2023, PT claims began to increase again. The most common types of PT interventions were therapeutic exercises, manual therapy, and neuromuscular reeducation. In 2023, the most recent year of full data available, Category A cancers made up 38% of all cancer certifications, with prostate and breast cancer being the most common. Category A cancers were evaluated together due to prior existing evidence outlining significant benefit from PT intervention. In total, Category A cancers represent over 14,000 Program members. Less than 1% of members with a Category A cancer had a PT related claim in 2023. Discussion/Significance of Impact: The mission of the Program is to provide quality and compassionate medical care and treatment to our members. Better understanding the utilization of PT services provided by the Program will allow us to increase awareness and support of interventions for members of our Program who could benefit from PT services.