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Interventional radiology (IR) services, including evaluation and management (E&M), are linked to procedural complexity. Practices should recognize the interdependence of E&M and procedural work for optimal IR practice management.

Keywords:
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Area of Science:

  • Radiology
  • Health Services Research
  • Medical Economics

Background:

  • Clinical evaluation and management (E&M) services may be undervalued in interventional radiology (IR) practices compared to procedural services.
  • Understanding the relationship between E&M services, procedural complexity, and the role of nonphysician practitioners (NPPs) is crucial for accurate practice valuation.

Purpose of the Study:

  • To assess if higher E&M provision correlates with increased IR procedural complexity.
  • To evaluate the contribution of NPPs in delivering IR services and their association with E&M and procedural work.

Main Methods:

  • Analysis of a 5% Medicare beneficiary claims sample from 2022.
  • Determination of the proportion of IR-related work (procedures and E&M) performed by radiologists and NPPs.
  • Assessment of associations between E&M services, procedural complexity, and the proportion of IR work.

Main Results:

  • Radiologists with a higher proportion of IR-related work (>90%) had significantly higher average work relative value units (wRVUs) per procedure (3.08 vs. 1.52) and more E&M claims per procedure (0.66 vs. 0.01) compared to those with lower IR focus (0-10%).
  • NPPs' work shifted from predominantly procedural (84.5%) in non-IR focused practices to predominantly E&M (86.0%) in IR-focused practices.
  • Higher IR procedural complexity was associated with higher E&M billing per procedure.

Conclusions:

  • Radiologists dedicating a higher proportion of their work to IR procedures also billed more E&M claims per procedure and handled more complex cases.
  • Practice leaders must consider the integrated nature of procedural and E&M services, not in isolation, for effective interventional radiology practice management.