Background Tonsillectomy and adenotonsillectomy are among the most common ENT procedures in Australia. In regional areas, large geographical distances can delay recognition and management of post-tonsillectomy bleeding (PTB), a potentially life-threatening complication. Toowoomba Hospital (TH) services a catchment of over 88,000 km² and advises patients residing more than 45 minutes away to remain within close proximity to an ENT-equipped facility for 10 days post-operatively. Accommodation is subsidised at $70 per night each for the patient and one caregiver, equating to $1,400 for the recommended period. This study evaluates the cost-effectiveness of this policy. Methods A retrospective review of 148 tonsillectomy procedures performed between 1 June and 31 December 2024 was conducted. Regional patients were defined as residing more than 45 minutes from TH. Data collected included adherence to recovery advice, PTB readmissions, return-to-theatre events, and aeromedical retrievals. Aeromedical retrieval costs were estimated at $6,000–$8,000 per flight hour. Results Patients resided between 60 km and >800 km from Toowoomba, with a median distance of 150 km. The PTB readmission rate was 11.5%, with a return-to-theatre rate of 1.4%. In the non-adherent cohort (18.6%), three patients presented to local emergency departments with PTB. Two required aeromedical retrieval to TH. One required return-to-theatre. One PTB was managed locally without ENT input. Estimated retrieval costs totalled $24,000–$32,000, substantially exceeding the total accommodation subsidy per patient. A cost-neutral analysis indicated that preventing eight or more retrievals would offset the total accommodation cost. Overall, the accommodation policy demonstrated a favourable cost-benefit ratio and may reduce retrieval demand and clinical risk. Conclusion Subsidized patient accommodation following tonsillectomy appears to be a cost-effective and clinically prudent strategy for regional ENT services.