Abstract
Objectives: Utilization of clinician-performed head and neck ultrasound
among diagnostic radiologists, otolaryngologists, endocrinologists, and
general surgeons, using Medicare Provider Utilization and Payment Data
available through CMS.gov. Estimation of the potential impact
clinician-performed ultrasounds may have on the traditional model of
radiology-based ultrasound exams. Design: From 2012-2015, 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 HCPCS code and a filter was applied to
include the following codes: 76536 Ultrasound, soft tissues of the head
and neck, diagnostic; 76942 Ultrasonic guidance for needle placement;
10022 Fine needle aspiration, with imaging guidance. Setting: The
Medicare Provider Utilization and Payment Data: Physician and Other
Supplier Public Use File, available through the Centers for Medicare &
Medicaid Services. Participants: Diagnostic Radiology (DR),
Endocrinology (ENDO), General Surgery (GS), and Otolaryngology (OTO).
Main outcome measures: Charges submitted, facility vs. non-facility,
reimbursements, and superusers. Results and Conclusions: In 2015, OTOs
submitted charges for 2.1% of all head and neck diagnostic ultrasounds
(76536) performed on Medicare beneficiaries. DRs submitted more 76536
charges from 2012-2015, ENDOs to a lesser degree, and OTO and GS
remained flat in charges. 10.5% of OTOs in the PUF submitted more than
100 charges apiece during 2015, as compared to a smaller proportion of
radiologists (4.5%) who did so. Among surgeons in 2015, OTOs performed
more diagnostic HNUS than GSs, and the percentage of OTOs performing US
compared to their specialty peers was 3.5 times higher than GSs.