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Professional Services Rendered by Nurse Practitioners and Physician Assistants Employed by Radiology Practices: Characteristics and Trends From 2017 Through 2019

Santavicca, Stefan; Hughes, Danny R; Rosenkrantz, Andrew B; Rubin, Eric; Duszak, Richard
PURPOSE/OBJECTIVE:With radiology practices increasingly employing nonphysician practitioners (NPPs), we aimed to characterize specific NPP clinical roles. METHODS:Linking 2017 to 2019 Medicare data sets, we identified all claims-submitting nurse practitioners and physician assistants (together NPPs) employed by radiologists. NPP-billed services were identified, weighted by work relative value units, and categorized as (1) clinical evaluation and management (E&M), (2) invasive procedures, and (3) noninvasive imaging interpretation. NPP practice patterns were assessed temporally and using frequency analysis. RESULTS:As the number of radiologist-employed NPPs submitting claims increased 16.3% (from 523 in 2017 to 608 in 2019), their aggregate Medicare fee-for-service work relative value units increased 17.3% (+40.0% for E&M [from 79,540 to 111,337]; +5.6% for procedures [from 179,044 to 189,003]; and +74.0% for imaging [from 5,087 to 8,850]). The number performing E&M, invasive procedures, and imaging interpretation increased 7.6% (from 329 to 354), 18.3% (from 387 to 458), and 31.8% (from 85 to 112), with 58.2%, 75.3%, and 18.4% billing those services in 2019. Paracentesis and thoracentesis were the most frequently billed invasive procedures. Fluoroscopic swallowing and bone densitometry examinations were the most frequently billed imaging services. By region, NPPs practicing as majority clinical E&M providers were most common in the Midwest (33.5%) and South (33.0%), majority proceduralists in the South (53.1%), and majority image interpreters in the Midwest (50.0%). CONCLUSIONS:As radiology practices employ more NPPs, radiologist-employed NPPs' aggregate services have increased for E&M, invasive procedures, and imaging interpretation. Most radiologist-employed NPPs perform invasive procedures and E&M. Although performed by a small minority, imaging interpretation has shown the largest relative service growth.
PMID: 36008228
ISSN: 1558-349x
CID: 5338462

Editor's Notebook: January 2023 [Editorial]

Rosenkrantz, Andrew B
PMID: 36542747
ISSN: 1546-3141
CID: 5468532

The Yellow Journal: Ongoing Growth in 2022

Rosenkrantz, Andrew B
PMID: 36542746
ISSN: 1546-3141
CID: 5468522

Editor's Notebook: December 2022 [Editorial]

Rosenkrantz, Andrew B
PMID: 36409769
ISSN: 1546-3141
CID: 5384082

Editor's Notebook: November 2022 [Editorial]

Rosenkrantz, Andrew B
PMID: 36269694
ISSN: 1546-3141
CID: 5359062

Editor's Notebook: October 2022 [Editorial]

Rosenkrantz, Andrew B
PMID: 36135969
ISSN: 1546-3141
CID: 5335552

Editor's Notebook: September 2022 [Editorial]

Rosenkrantz, Andrew B
PMID: 35994423
ISSN: 1546-3141
CID: 5335972

Recognition for Reviewers in a Time of Transparency [Editorial]

Rosenkrantz, Andrew B
PMID: 36043883
ISSN: 1546-3141
CID: 5337692

Editor's Notebook: August 2022 [Editorial]

Rosenkrantz, Andrew B
PMID: 35868027
ISSN: 1546-3141
CID: 5276062

Editor's Notebook: July 2022 [Editorial]

Rosenkrantz, Andrew B
PMID: 35723243
ISSN: 1546-3141
CID: 5281822