Obstetric Ultrasound Utilization and Expenditures in a Commercially Insured Population (2016-2022)

To analyze obstetric ultrasound utilization and expenditures per live birth delivery among the commercially insured from 2016 to 2022 and present updated trends and variation in use by type of ultrasound and across subgroups.

In this retrospective United States-based cohort study, obstetric ultrasound utilization and expenditures during pregnancy were measured for a cohort of all deliveries with at least 28-week gestation that resulted in a live birth between January 1, 2017 and December 31, 2022, using the Health Care Cost Institute commercial claims database. We report utilization trends and the clinical and sociodemographic factors correlated with utilization using descriptive statistics and negative binomial regression.

In our sample of 1,731,823 pregnancies, there were an average of 5.3 (SD ± 3.9) claims for obstetric ultrasounds per live birth delivery. After adjusting for covariates, the number of ultrasounds per live birth increased by 8.3% and inflation-adjusted spending for these ultrasounds increased 5.6% over the 7-year study period (p < .001); though utilization decreased during the COVID-19 pandemic in 2020. Follow-up ultrasound (CPT 76816) was the fastest growing procedure.

Obstetric ultrasound utilization and expenditures increased from 2016 to 2022. Information on the variation in patterns and trends related to obstetric ultrasound use may assist policy makers in their assessment of resource utilization and approach to reimbursement design, such as obstetric bundled payments.