Medicare fee-for-service payments for many kinds of imaging are now higher to nonradiologists than to radiologists, according to a study published in the Journal of the American College of Radiology.

The study, which analyzed all discretionary non-invasive diagnostic imaging (NDI) codes in Medicare Part B fee-for-service payments to doctors from 1998 to 2008, found that by the last year of the study nonradiologists received 4 percent more in payments than radiologists.

"Because most imaging by nonradiologists is self-referred, whereas radiologists generally do not have the opportunity to self-refer, this should be of interest and concern to policy makers and payers," Dr. David C. Levin, lead author of the study and professor of radiology with the Jefferson Medical College of Thomas Jefferson University in Philadelphia, said in a statement.
The researchers argued the difference came about as more and more nonradiologists entered the imaging business and radiologists were harder hit by the Deficit Reduction Act of 2005. The bill, which took effect in 2007, lowered reimbursements for imaging.

In 1998, Part B payments to radiologists for discretionary NDI amounted to $2.563 billion. For nonradiologists, it was only $2.020 billion, the study said. But in 2008, nonradiologists received $4.807 billion in payments, versus only $4.648 billion for radiologists.

The researchers also parceled out data for cardiologists, as after radiologists, they're the specialty that receives the most payments for imaging services, the authors said. The researchers found that cardiologists went from $1.018 billion in fee-for-service NDI payments in 1998, to $2.752 billion in 2008.

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