by
Gus Iversen, Editor in Chief | September 22, 2025
Office-based imaging studies interpreted by non-physician practitioners are more likely to be repeated within 90 days than those read by radiologists, according to new research from the Harvey L. Neiman Health Policy Institute.
The study, published in the
Journal of the American College of Radiology, analyzed more than 1.3 million Medicare claims from 2013 to 2022. Researchers examined repeat imaging rates for studies read by nurse practitioners and physician assistants — grouped as non-physician practitioners (NPPs) — and compared them with those interpreted by radiologists. Repeat imaging was defined as a second study from the same modality and anatomic region conducted within 90 days of the original exam.
Overall, 12.5% of imaging studies were followed by repeat imaging, though rates varied by modality. Radiography had the highest repeat rate at 15.9%, followed by ultrasound at 4.6% and MR at 3.8%.
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When broken down by interpreter type, repeat rates were consistently higher for studies initially read by NPPs. For radiography, the repeat rate was 20.4% for NPPs versus 14.6% for radiologists. Ultrasound showed a repeat rate of 11.6% for NPPs compared to 4.5% for radiologists. MR followed a similar pattern, with rates of 8.8% versus 3.8%.
“Repeat imaging rates were substantially higher for imaging studies interpreted by NPPs for each modality studied,” said Eric Christensen, Ph.D., research director at the Neiman Institute and lead author. He added that even after adjusting for patient characteristics, the odds of repeat imaging were significantly higher when NPPs were the initial interpreters: 35% for radiography, 141% for ultrasound, and 156% for MR.
While the study does not define an optimal repeat rate, the authors suggest that differences in interpretation may have downstream effects on diagnostic accuracy, treatment delays, and healthcare spending.
“Repeat imaging is a potential source of unnecessary imaging when it can be avoided with high-quality initial imaging,” said Elizabeth Rula, Ph.D., executive director of the Neiman Institute.
