Interventional Radiologists Increase Billing for Nonprocedural Care Despite Workforce Decline
A recent study highlights a notable rise in nonprocedural billing among interventional radiologists (IRs), even as the number of practicing IR physicians within Medicare has declined. Published in JACR, the research shows that while fewer interventional radiologists are active today, those remaining are performing more evaluation and management (E&M) work—reflecting a broader shift toward comprehensive patient care.
In response to growing case complexity and evolving clinical expectations, many IRs are expanding their role beyond procedural work to include consultative and longitudinal care. One study found that interventional radiologists collectively billed $9.3 million in E&M charges in a single year, with physicians who provided these services often performing higher-reimbursement interventions.
The analysis, led by Dr. Zain S. Hussain of the University of Medicine and Health Sciences in New York, revealed a 35% increase in total E&M claims from 2013 to 2022. This growth occurred despite a 7.2% reduction in the number of Medicare-participating interventional radiologists during that time—from 12,483 in 2013 to 11,585 in 2020.
Researchers used Medicare billing data to identify IRs whose annual activity included at least 10% interventional radiology services. From this group, they tracked changes in E&M billing behavior. Total E&M claims rose from 149,481 in 2013 to 201,825 in 2022, and estimates suggest that figure would have been higher by roughly 10,776 claims if IR numbers had remained stable.
These findings point to a significant increase in per-physician billing. The average number of E&M claims per IR grew from 12 in 2013 to 17.4 in 2022, marking a 45% rise. Moreover, the proportion of IRs submitting more than 11 E&M claims annually increased from 11% (1,347 physicians) to 13% (1,522) over the study period.
The authors attribute these changes to two primary trends: a growing subset of IRs actively engaged in clinical practice, and those same clinicians submitting higher volumes of E&M claims. Essentially, a relatively small—but expanding—group of IRs is driving the bulk of the nonprocedural billing growth.
The findings support the view that modern interventional radiologists are increasingly equipped and committed to delivering full-spectrum care. Current IR training programs have placed greater emphasis on clinical competencies, enabling new physicians to manage consults, follow-ups, and inpatient care more effectively. The study also suggests that the rise of inpatient consult services involving IRs and integration into hospital care teams may be contributing to the observed billing increase.
A decade ago, there was ongoing debate about whether interventional radiology was truly evolving into a clinical specialty. The study authors conclude that the specialty has made clear progress in this direction. By embracing patient engagement and expanded clinical responsibilities, IRs are boosting their relevance, visibility, and influence in today’s competitive healthcare environment.