Interventional radiologists ‘markedly’ increase billing for nonprocedural work, despite drop in overall doc count
Interventional radiologists have “markedly” increased their billing for nonprocedural work over the last decade, despite a drop in the number of such docs practicing in Medicare, according to new research.
Amid the increasing complexity of cases, rads have sought to perform more “evaluation and management” outside IR operating rooms, establishing long-term patient relationships and ensuring comprehensive care. Interventional radiologists tallied $9.3 million in allowable charges from evaluation and management (E&M) in a single year, one study found, and docs who did so tended to perform higher-reimbursement procedures.
Researchers recently measured the prevalence of interventional rads managing patients in this fashion, sharing their findings Tuesday in JACR. They discovered a 35% increase in total E&M claims since 2013, despite a 7% drop in the number of practicing interventional radiologists.
“These findings underscore IR’s accelerating transition toward comprehensive patient care, with significant implications for training, practice management, and the specialty’s role within the broader healthcare landscape,” lead author Zain S. Hussain, MD—with the University of Medicine and Health Sciences, New York, at the time of the study—and colleagues concluded.
Researchers gathered their data from Medicare files, pinpointing practicing IRs who reached a minimum 10% threshold of annual work based on IR billing codes. They found that the number of practicing interventional radiologists dropped from 12,483 in 2013 down to 11,585 by 2020 (a -7.2% decrease). Meanwhile, the total overall evaluation and management claims among interventional radiologists jumped 35%, from 149,481 claims in 2013 up to 201,825 by 2022. Absent the drop in specialists, this number would have been another 10,776 claims higher, the authors estimated.
“Taken together, these trends underscore a meaningful shift in IR practice and echo previous work that have described an increasing awareness and importance of nonprocedural services provided by IRs, who are moving beyond the traditional confines of the hospital,” the authors wrote.
Hussain and colleagues contend the 52,344 uptick was driven primarily by increased claims per IR physician. This figure rose “substantially” during the study period, from 12 per doc in 2013 up to 17.4 by 2022 (a 45% increase). The authors also highlighted growth in the number of IRs submitting more than 11 E&M claims per year, from about 11% (or 1,347) in 2013 up to 13% (or 1,522) in the final year of the study.
“Therefore, we highlight that the per‐doc billing increase is itself driven by (1) a rising fraction of ‘active clinical’ IRs and (2) higher claims among those active IRs,” the study authors noted. “In essence, only a small fraction of actively practicing IR physicians do most of the clinical billing, but that fraction is growing and billing more.”
Researchers believe their findings indicate that today’s interventional radiologist appears “better equipped and more committed to providing comprehensive patient care.” Previous studies have shown that modern IR training programs are increasingly emphasizing these clinical skills, helping to foster a new generation of specialists who are “adept at integrating consultative and follow-up services.” Hussain et al. also speculated that the emergence of inpatient consult services for IRs, integrating the specialty into hospitalist care teams, may contribute to these higher numbers.
“A decade ago, discussions centered around whether IR was truly evolving into a clinical specialty or merely dabbling in patient care,” the authors concluded. “Our analysis highlights a steady upward clinical trajectory supporting the notion that IR is actively pursuing the ‘clinical imperative’ set forth by specialty leadership. Meaningful patient engagement stands at the forefront of this transformation, catalyzing continued growth, elevating the specialty’s visibility, and securing IR's influential position within the competitive healthcare landscape.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.