David C. Levin MD, Presenter: Consultant, HealthHelp Board of Directors, Outpatient Imaging Affiliates, LLC

Vijay Madan Rao MD, Abstract Co-Author: Nothing to Disclose

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

To determine whether anecdotal reports of acquisition of MRI units by orthopedic surgeons (OSs) in their offices are confirmed by nationwide Medicare data. Previous studies have focused on who interprets the exams, rather than on who owns the equipment.

The nationwide Medicare Part B datasets for 2000 through 2005 were reviewed. Medicare’s CPT-4 and place-of-service codes were used to identify all musculoskeletal (MSK) MRI studies performed in private offices. Physician specialty codes were used to identify the specialty of the provider who owned the MRI unit. Ownership was determined by tabulating all approved technical-component and global claims. Professional-component claims were excluded to allow us to assess ownership, rather than who interpreted the study. Trends were examined among OSs, radiologists, all other physicians as a group, and independent diagnostic testing facilities (IDTFs).

Total claims by the 4 provider groups for Medicare MSK MRI studies in private offices were 707,603 in 2000, increasing to 1,689,154 in 2005 (+139%). MSK MRI claims from units owned by OSs rose from 28,979 in 2000 to 155,301 in 2005 (+436%). Medicare payments for these exams in OS offices totaled $77,046,449 in 2005. Among all MRI studies of all types in OS offices in 2005, 96% were MSK (either spine or extremity) exams. Claims submitted by all other nonradiologist physicians as a group for MSK MRI increased from 41,546 in 2000 to 137,965 in 2005 (+232%). Among radiologists, private office MSK MRI claims from units they owned increased from 503,281 in 2000 to 924,714 in 2005 (+84%). IDTF claims for MSK MRI rose from 133,797 in 2000 to 471,174 in 2005 (+252%).

Ownership of MRI units by OSs is a rapidly growing trend . MRI claims from OS offices are increasing at a much faster rate than those from radiologists’ offices. The vast majority of MR scans performed in OS offices are related to the musculoskeletal system. Despite the rapid rise in MSK claims from MRI units owned by OSs, they are still far outweighed by claims from units owned by radiologists and IDTFs.

Does not apply.

Levin, D, Rao, V, Parker, L, Frangos, A, Sunshine, J, Musculoskeletal MRI Performed on Units Owned by Orthopedic Surgeons: A Rapidly Growing Trend.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5007080.html