Low billing rates for pediatric sedation fee on magnetic resonance imaging.

BACKGROUND: Sedating children for magnetic resonance imaging (MRI) requires special consideration. The 2018 revision of social insurance allows additional fees to be calculated for pediatric MRIs performed under sedation in Japan. The number and trend of actual claims since this addition was established is unknown.

METHODS: To analyze the claims of additional fees for pediatric sedated MRI imaging after fiscal year (FY) 2018, the actual claims of the addition in inpatient and outpatient practice was analyzed using publicly-available data from the Ministry of Health, Labour and Welfare (MHLW). We analyzed the calculation rate for all MRI scans. Annual changes in the actual number and calculation rate were analyzed. The ratio of the number of additional fees to the overall number of pediatric radiological procedures was used to examine the geographic disparity.

RESULTS: The number of calculations from FY 2018 to FY 2020 was available; in FY 2020, only 1347 additions were calculated, corresponding to 0.35% of the total number of MRI scans. The number of fees showed a decreasing trend. Most cases were in the 0-4 years age group: however, there were a few cases in the 10-14 years age group without such a decrease. The relative number of calculations by prefecture showed a disparity of up to 14 times.

CONCLUSIONS: The requirements for the addition of pediatric MRI sedation are strict and not fully utilized in pediatric sedation for MRI. Measures such as relaxing the requirements for the fee are needed to make MRI-related sedation safer. (249/250words) .