David C. Levin MD, Presenter: Consultant, HealthHelp, LLC 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

To study recent trends in acquisition of CT scanners for their offices by otolaryngologists (ENTs) and neurologists. Both specialties have become increasingly interested in acquiring their own advanced imaging equipment. This is of concern to policymakers and payers, as well as neuroradiologists, because it creates an opportunity for self-referral.

The nationwide Medicare Part B databases for 2002-2012 were our data sources. All CPT codes for diagnostic CT were selected. Medicare’s physician specialty codes were used to identify claims submitted by ENTs and neurologists. Ownership of the units on which scans were performed was determined by tabulating global and technical component CT claims from those specialties, but excluding professional component claims. Data for other specialties were also studied.

In 2002, there were 8123 CT scans performed on Medicare patients on units owned by ENTs. This rose to a peak of 48,813 in 2009 (+501%), then declined to 40,121 in 2012 (-18% vs 2009). In 2002, there were 6773 Medicare CT scans performed on units owned by neurologists. This rose to a peak of 13,016 in 2009 (+92%), then declined to 7729 in 2012 (-41% vs 2009). Some of the recent declines were due to CT code bundling. Several other nonradiologic specialties performed more CTs on scanners in their offices than ENTs or neurologists. For example, 2012 CT totals for primary care physicians were 120,473; for urologists 92,375; for cardiologists 62,638; and for other internal medicine specialists 147,164. Radiologists’ total office volume in 2012 was 1,393,181.

During the previous decade, ENTs were more aggressive than neurologists in acquiring CT scanners for their offices. Medicare CT scans on in-office units owned by ENTs grew 501% from 2002-2009. Growth among neurologists was considerably less (92%). Volumes of CTs done on in-office units owned by the 2 specialties declined after 2009, but the decline was proportionately less among ENTs (18% vs 41% for neurologists). In spite of the growth of in-office CT ownership by the 2 specialties after 2002, their total volumes were small compared with those among several other clinical specialties and among radiologists. It does not appear that they will threaten the role of neuroradiologists in the near future.

not applicable.

Levin, D, Rao, V, Parker, L, Frangos, A, Growth in Ownership of CT Scanners among Otolaryngologists and Neurologists in Recent Years: How Important Is It?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003639.html