Recent Payment and Utilization Trends in Radionuclide Myocardial Perfusion Imaging: Comparison Between Self-Referral and Referral to Radiologists

In recent years, there have been very sharp increases in the costs and utilization of MPI among cardiologists compared with radiologists. Most of the growth occurred in cardiologists' private offices. In hospital settings, radiologists still do more MPI examinations than cardiologists. Because MPI is a highly reimbursed procedure and there is no evidence that coronary disease is increasing in frequency in the Medicare population, this trend raises a concern about inappropriate self-referral. This is particularly true in view of the facts that the utilization of a competing procedure such as SE also continues to increase among cardiologists and that MPI is not substituting for an invasive procedure such as diagnostic CA.