Common Interventional Radiology Procedures Performed by Physician Assistants and Nurse Practitioners: Medicare Trends from 2010-2018

Monday, March 6, 2023

12:00 PM – 1:00 PM

Location: Phoenix Convention Center, North Ballroom 120 D

Poster Presenter(s)

Will S. Lindquester, MD

Independent IR Resident
Emory University School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

CH

C. Matthew Hawkins, MD, FSIR

Associate Professor
Emory University
RD

Rajoo Dhangana, MD

Assistant Professor
University of Pittsburgh Medical Center

Disclosure(s):

Will S. Lindquester, MD: No financial relationships to disclose

Purpose: To analyze trends in volume of common interventional radiology (IR) procedures performed by physician assistants (PAs) and nurse practitioners (NPs).

Materials and Methods: Peripherally inserted central catheter (PICC) placement, tunneled central catheter placement, port placement, image-guided paracentesis and thoracentesis, gastrostomy and gastrojejunostomy exchange, and percutaneous liver and kidney biopsy were identified as IR procedures sometimes performed by PAs and NPs. Total volume and percent share of these procedures performed by PAs and NPs were extracted from the Medicare Part B Physician/Supplier Procedure Summary Master File from 2010 to 2018 using CPT codes. Because PAs and NPs do not have specialty-specific identifiers, procedures performed by all PAs and NPs were included.

Results: In 2010, 6.34% of these common IR procedures were performed by PAs, increasing to 8.33% in 2018 (31.4% increase). In 2010, 1.63% were performed by NPs, increasing to 2.85% (75.0% increase). In 2010, PAs performed 59,574 of these procedures, and NPs performed 15,327 procedures. In 2018, PAs performed 83,102 procedures (31.4% increase), and NPs performed 28,479 procedures (75.0% increase). The greatest share was for PICC placement (13.37% for PAs and 5.01% for NPs in 2018) and image-guided paracentesis (11.11% for PAs and 4.71% for NPs in 2018). The lowest share was for renal biopsy (0.96% for PAs and 0.18% for NPs in 2018) and liver biopsy (1.77% for PAs and 0.32% for NPs in 2018).

Conclusion: Procedures performed by advanced practice providers in IR practices has been growing over the past decade, most notably vascular access procedures and paracentesis.