Jessica Kobil MD, MPH, 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

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

To study recent trends in utilization of screening and diagnostic mammography, breast ultrasound (US), and breast MRI in the Medicare population. A secondary purpose was to see what percentage of mammograms was performed on digital units.

The Medicare Physician/Supplier Procedure Summary Master Files for 2004 through 2009 were the data sources. CPT-4 codes for the four examinations were selected. There are separate codes for screen-film and digital mammography. Procedure volume counts were determined by tabulating global and professional component claims. Utilization rates per 1000 women beneficiaries were calculated by dividing volume counts by the number of thousands of Medicare women beneficiaries for each year. Trends were studied and compound annual growth rates were calculated. Interventional procedures were excluded.

Overall rates per 1000 for screening mammography increased from 301.0 in 2004 to 322.5 in 2009, representing annual growth of 1.4%. Diagnostic mammography rates decreased from 96.5 in 2004 to 91.5 in 2009, representing annual change of -1.1%. Breast US rates increased from 34.3 in 2004 to 43.1 in 2009, an annual growth of 4.7%. Breast MRI rates increased from 0.9 in 2004 to 3.9 in 2009, an annual growth of 33.9%. In 2009, 69.9% of all screening mammograms and 72.1% of all diagnostic mammograms were digital.

In the Medicare population in recent years, the utilization rate of screening mammography per 1000 women is slowly rising, while that of diagnostic mammography is slowly falling. By 2009, there were 3.5 times as many screening as diagnostic mammograms. The utilization rate of breast ultrasound is rising moderately rapidly and by 2009, there were almost half as many US exams performed per 1000 women as diagnostic mammograms. The use of breast MRI is growing but remains low – less than 10% that of ultrasound. A large majority of both screening and diagnostic mammograms are done on digital units.

Not applicable.

Kobil, J, Levin, D, Parker, L, Rao, V, Breast Imaging Utilization Trends in the Medicare Population from 2004 to 2009.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004604.html