Vijay Madan Rao MD, Presenter: Nothing to Disclose

David C. Levin MD, Abstract Co-Author: Consultant, HealthHelp Board of Directors, Outpatient Imaging Affiliates, LLC

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

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

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

There is concern among payors and policymakers about increasing utilization of imaging. Our purpose was to study recent growth trends in noninvasive imaging of the abdomen and pelvis among both radiologists and nonradiologists.

We used the nationwide Medicare Part B Physician/Supplier Procedure Summary Master Files for 2000 through 2005. These files provide counts of all procedures by the specialty of the physician provider. CPT codes for noninvasive imaging of the abdomen and pelvis were grouped into 5 categories: CT, MR, US, plain radiography (XR), and GI fluoroscopy (fluoro). Utilization rates per 1000 Medicare beneficiaries were calculated and trends assessed for radiologists and nonradiologists.

Total abdomen/pelvis imaging rates per 1000 were 469.7 in 2000, rising to 551.1 in 2005 (+17%). The 2000-2005 rate changes in the 5 categories were: CT 142.5 to 239.3 (+68%); US 138.3 to 142.2 (+3%); XR 135.8 to 125.4 (-8%); fluoro 49.3 to 34.8 (-29%); MR 3.9 to 9.3 (+138%). Among radiologists, the overall rate rose from 386.3 in 2000 to 481.4 in 2005(+25%). Rate changes for radiologists in the 5 categories were: CT 133.4 to 228.8 (+72%); US 85.6 to 100.6 (+17%); XR 117.8 to 110.1 (-7%); fluoro 46.0 to 33.5 (-27%); MR 3.5 to 8.4 (+140%). Among nonradiologists, the overall rate dropped from 61.0 in 2000 to 56.6 in 2005 (-7%). Their only 2 significant areas of involvement were US [45.8 in 2000 to 36.8 in 2005 (-20%)] and XR [11.5 in 2000 to 12.4 in 2005 (+8%)]. In 2005, nonradiologists’ share of the 5 imaging modalities were: CT 3%, US 26%, XR 10%, fluoro 3%, MR 2%; overall 10%.

The utilization rate of abdominal/pelvic imaging grew modestly from 2000 to 2005. Almost all the growth was in CT. Radiologists’ overall rate increased, while nonradiologists’ rate dropped. Radiologists strongly predominate in all modalities, except possibly for US, where nonradiologists had a 26% share in 2005. Even so, abdominal/pelvic US by nonradiologists dropped 20% over the study period, while US by radiologists increased by 17%.

Does not apply.

Rao, V, Levin, D, Parker, L, Frangos, A, Sunshine, J, Recent Utilization Trends and Practice Patterns in Abdominal Imaging among Radiologists and Nonradiologist Physicians.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5003174.html