Recent trends in utilization of vascular ultrasound among radiologists, surgeons, cardiologists, and other physicians.

PURPOSE: To determine how much vascular ultrasound is performed by the various medical specialties and to assess the utilization trends among them in recent years.

METHODS AND MATERIALS: The nationwide Medicare Part B databases for 1998 through 2004 were used. The authors studied the 15 Current Procedural Terminology, Version 4, codes in the 93000 series pertaining to vascular ultrasound and determined the volume of examinations performed under global and professional component claims. Using Medicare's physician specialty codes, utilization rates per 1,000 Medicare beneficiaries and trends in these rates were determined for radiologists, surgeons, cardiologists, other physicians, and independent diagnostic testing facilities (IDTFs) over the 6-year period. Market shares were calculated for the different specialties.

RESULTS: In 2004, among all specialties, 171.8 vascular ultrasound studies were performed per 1,000 Medicare beneficiaries, an increase of 49% over 1998. For the various specialty groups, the 2004 utilization rates and percentage changes since 1998 were as follows: radiologists, 70.8 per 1,000 (+44%); surgeons, 44.6 per 1,000 (+47%); cardiologists, 23.1 per 1,000 (+93%); other physicians, 24.0 per 1,000 (+52%); and IDTFs, 9.3 per 1,000 (+12%). Market shares in 2004 were as follows: radiologists, 41.2%; surgeons, 26.0%; cardiologists, 13.4%; other physicians, 14.0%; and IDTFs, 5.4%. Although the percentage change in utilization rates over the 6 years was highest among cardiologists, the addition of new case volume was highest among radiologists. Radiologists added 1,110,961 new studies between 1998 and 2004, whereas surgeons added 713,251, cardiologists added 489,958, other physicians added 401,601, and IDTFs added 89,077.

CONCLUSIONS: Radiologists have the largest market share in vascular ultrasound. Between 1998 and 2004, they added more new volume than other specialties. Utilization trends suggest that radiologists will continue to have a strong role in this major aspect of vascular imaging.