Who gets paid for diagnostic imaging, and how much?

PURPOSES

To determine the apportionment of Medicare Part B payments for noninvasive diagnostic imaging among radiologists and other specialists and to ascertain the trends in these payments over a recent 5-year period.

METHODS AND MATERIALS

Using the nationwide Medicare Part B databases for 1997 through 2002, all payments were calculated for physician services for noninvasive diagnostic imaging codes in the 70,000 Current Procedural Terminology, Version 4 series and those codes in the 90,000 series pertaining to echocardiography and vascular ultrasound. Imaging studies were grouped into 26 different categories depending on type and modality. The 108 Medicare physician specialty codes were used to group payments into 20 different specialist categories. The percentage shares for each specialty group in 1997 and 2002 were calculated. Percentage changes in payments between 1997 and 2002 were determined.

RESULTS

In 2002, Medicare Part B paid almost $7.7 billion for noninvasive diagnostic imaging services. Radiologists received 48.3% of these payments, and cardiologists received 22.8%. Between 1997 and 2002, overall payments to physicians for noninvasive diagnostic imaging rose by 78%. Payments to radiologists increased by 65%, while payments to cardiologists increased by 105%. Primary-care physicians received 8.3% of 2002 payments, while 10.2% went to independent diagnostic testing facilities or multispecialty groups. For the latter two entities, the specialties of the physician providers could not be determined.

CONCLUSION

Radiologists receive only about half of all Medicare Part B reimbursements for noninvasive diagnostic imaging. Cardiologists receive almost one-quarter. Payments to cardiologists are rising more rapidly then to any other specialty group and considerably more rapidly than payments to radiologists.