Head and Neck Ultrasound Utilization Rates: 2012 to 2019

We measured utilization of clinician-performed head and neck ultrasound among otolaryngologists, endocrinologists, and general surgeons, using Medicare Provider Utilization and Payment Data.

Retrospective analysis of Medicare billing database.

University.

For each year, the files were filtered to include 4 provider types: Diagnostic Radiology (DR), Endocrinology (ENDO), General Surgery (GS), and Otolaryngology (OTO). Billable procedures are listed by Healthcare Common Procedure Coding System code and a filter was applied to include 76536 Ultrasound, soft tissues of the head and neck.

In 2019, OTOs submitted charges for 2.1% of all head and neck diagnostic ultrasounds (76536) performed on Medicare beneficiaries. For each year 2012 to 2019, DRs submitted the most charges, followed by ENDOs, and then OTO and GS. Charges for all groups increased in a proportional manner across the 8-year period. 14.5% of OTOs submitted more than 100 charges apiece during 2019, that is, "super users." The percentage of super users within each specialty increased from 2012 to 2019. Overall, the data support an ever-increasing use of head and neck ultrasound (HNUS) among all provider types.

Even with increased use among OTOs, this specialty only accounted for a small percentage of head & neck diagnostic ultrasounds performed on Medicare beneficiaries in 2019. Changes in volume of nonradiology point-of-care HNUS was not associated with changes in DR volume. A greater proportion of OTOs than DRs are "super users" among the ultrasound users within their specialty, performing more than 100 exams/year.

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