Emergency Department Imaging: Uncompensated Services Rendered by Radiologists Nationwide

Purpose: The aim of this study was to examine characteristics of uncompensated services rendered by radiologists to emergency department (ED) patients. Methods: Using deidentified billing claims for 2,935 radiologists from 40 states from 2009 through 2012, 18,475,491 services rendered to ED patients were identified. Analysis focused on the 133 of 830 procedure codes that comprised 99.0% (18,296,734) of all rendered services. The frequency, magnitude, and other characteristics of uncompensated (defined as zero payment) radiologist services were analyzed. National 2012 Medicare Physician Fee Schedule amounts were used to estimate service dollar values. Results: Of 2,935 radiologists, 2,835 (96.6%) provided uncompensated care to ED patients, averaging $2,584 in professional services per physician per service month. Radiologists received no compensation at all for 28.4% of services (5,194,732 of 18,296,734). Just 8 procedure codes describing various chest, foot, and ankle radiographic and brain, abdominal and pelvic, and cervical spine CT examinations accounted for 51.0% of all imaging services rendered to ED patients. CT represented 31.2% of all services but accounted for 64.8% of uncompensated dollars. Although the uninsured received only 15.8% of all services, they accounted for 52.3% of all uncompensated services (2,714,506). Conclusion: More than 28% of services rendered by radiologists to ED patients are uncompensated, corresponding to $2,584 per month per physician. That frequency and magnitude could have patient access implications.