Vijay Madan Rao MD, Presenter: Nothing to Disclose

David Carl Levin MD, Abstract Co-Author: Nothing to Disclose

Andrea J Frangos MPH, Abstract Co-Author: Nothing to Disclose

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Jonathan H. Sunshine PhD, Abstract Co-Author: Nothing to Disclose

To determine the level of participation by nonradiologist physicians in MR imaging. This may be an accelerating trend, according to some recent observations.

The Medicare Part B Master Summary datasets from 2001-2003 were used to identify all CPT-4 codes for MR imaging and the procedure volume within each code. The 108 Medicare provider specialty codes (one of which appears on every claim) were used to determine the specialty of the physician providers. Specialties were grouped into 23 categories to simplify data analysis. Procedure volume was tabulated for each specialty category, as were changes in that volume from 2001 to 2003. Studies performed by multispecialty groups and independent diagnostic testing facility (8% of the total) were excluded because the provider specialty cannot be determined in that subset.

The nonradiologist specialties with the highest Medicare MR imaging volume, and their percent changes from 2001 to 2003, were as follows: (a) neurologists – 70,791 in 2003, +20% from 2001 to 2003; (b) orthopedic surgeons – 51,162, +79%; (c) primary care physicians (PCPs) – 34,230, +62%; (d) radiation oncologists – 26,042, +90%; (e) neurosurgeons – 10,759, +41%. No other specialty performed more than 10,000 examinations. The number of MR examination by all nonradiologists in 2003 was 227,334, up 54% from 2001. By contrast, radiologists did 4,503,365 MR studies in 2003, up 38% from 2001. Radiologists’ share of all procedure volume in 2003 was 95%.

Radiologists strongly predominated in MR imaging in 2003. The other specialties’ shares are paltry by comparison. Those specialties with the highest levels of involvement are neurologists, orthopedic surgeons, PCPs, radiation oncologists, and neurosurgeons. Utilization by nonradiologists is growing at a faster rate than that by radiologists. Given numerous recent antecdotal reports of expansion by nonradiologists into MR, these trends will bear close watching in the future.

Rao, V, Levin, D, Frangos, A, Parker, L, Sunshine, J, Growth in MR Imaging among Nonradiologist Physicians in Recent Years.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4412649.html