Researchers examine if nonphysicians are interpreting more imaging studies

Physician assistants and nurse practitioners are performing more image-guided procedures, but nonphysician providers (NPPs) still read relatively few diagnostic imaging exams, according to a new analysis published in the American Journal of Roentgenology.

When NPPs do perform diagnostic imaging exams, they are more often radiography and fluoroscopy, explained Valeria Makeeva, MD, with Emory University in Atlanta, and colleagues.

The researchers looked at Physician/Supplier Procedure Summary Master Files spanning 1994 through 2015. They also used 2004–2015 Medicare Part B 5% Research Identifiable File Carrier Files to assess state-level variation in imaging services performed by NPPs.

“The frequency with which NPPs provide diagnostic radiology services nationally and regionally is unknown,” the researchers added. “As discussion continues regarding the optimal role of NPPs in radiology practices, this information could help inform discussions and future policy.”

Overall, diagnostic imaging services increased by 24% during the time period analyzed. During that same time imaging services rendered by NPPs jumped 14,711%, but that only represented .01% of all imaging performed.

Broken down by state, NPP-billed imaging was most common in South Dakota (7,987 services per 100,000 beneficiaries) and Alaska (6,842 services per 100,000 beneficiaries) and was least common in Hawaii (231 services per 100,000 beneficiaries) and Pennsylvania (478 services per 100,000 beneficiaries).

“Although considerable state-to-state variation exists in the rates in which NPPs render diagnostic imaging services, likely in part related to unique state level scope of practice laws and regulations, these rates are uniformly low,” said Richard Duszak, MD, professor of radiology and imaging sciences at Emory University and senior affiliate research fellow at the Neiman Institute, in a prepared statement. “At present, the near-term likelihood of NPPs acquiring substantial diagnostic imaging market share is extremely low."