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Research ArticlePRACTICE PERSPECTIVES

Evolving Use of fMRI in Medicare Beneficiaries

S. Asnafi, R. Duszak, J.M. Hemingway, D.R. Hughes and J.W. Allen
American Journal of Neuroradiology October 2020, DOI: https://doi.org/10.3174/ajnr.A6845
S. Asnafi
aFrom the Department of Radiology and Imaging Sciences (S.A., R.D., J.W.A.)
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R. Duszak
aFrom the Department of Radiology and Imaging Sciences (S.A., R.D., J.W.A.)
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J.M. Hemingway
cHarvey L. Neiman Health Policy Institute (J.M.H., D.R.H.), Reston, Virginia
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D.R. Hughes
cHarvey L. Neiman Health Policy Institute (J.M.H., D.R.H.), Reston, Virginia
dSchool of Economics (D.R.H.), Georgia Institute of Technology, Atlanta, Georgia
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J.W. Allen
aFrom the Department of Radiology and Imaging Sciences (S.A., R.D., J.W.A.)
bNeurology (J.W.A.), Emory University School of Medicine, Atlanta, Georgia
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  • FIG 1.
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    FIG 1.

    Functional MR imaging use in Part B Medicare beneficiaries from 2007 to 2017 by physician specialty group. Radiology (70554 + 70555) refers to the total billing of fMRI by this specialty. Radiology (70554) refers only to the 70554 CPT code. All other specialties reflect total billing.

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    FIG 2.

    Functional MR imaging use in Part B Medicare beneficiaries from 2007 to 2017 by place of a service group.

Tables

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    Table 1:

    CPT Codes for fMRI

    CPT CodeDescription
    70554fMRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration
    70555fMRI; requiring physician or psychologist administration; this is to be always reported with CPT code 96020
    96020Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or psychologist, with review of test results and report
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    Table 2:

    Site of service and specialty groups studied with the corresponding codes

    Site Group/Specialty GroupSites (Code)
    OutpatientOffice (11), outpatient hospital (19 and 22), independent clinic (49)
    InpatientInpatient hospital (21)
    Emergency departmentEmergency department (23)
    OtherOther: independent laboratory (81), skilled nursing facility (31), temporary lodging (16), mobile unit (15), home (12), and other place of service (99)
    RadiologyDiagnostic radiology (30), interventional radiology (94), and nuclear medicine (36)
    NeurologyNeurology (13)
    NeurosurgeryNeurosurgery (14)
    OthersAll other identifiable groups
    UnidentifiedUnidentified: independent diagnostic testing facility (47), single or multispecialty clinic or group practice (70), unknown physician specialty (99)
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Evolving Use of fMRI in Medicare Beneficiaries
S. Asnafi, R. Duszak, J.M. Hemingway, D.R. Hughes, J.W. Allen
American Journal of Neuroradiology Oct 2020, DOI: 10.3174/ajnr.A6845

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Evolving Use of fMRI in Medicare Beneficiaries
S. Asnafi, R. Duszak, J.M. Hemingway, D.R. Hughes, J.W. Allen
American Journal of Neuroradiology Oct 2020, DOI: 10.3174/ajnr.A6845
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