Evolution of Interventional Radiology Practice Phenotypes: Sedation, Clinical Integration, and Procedural Complexity in Medicare Claims Data, 2013-2023.
Interventional radiology physicians combining sedation and E/M billing perform embolization far more often
Evolution of Interventional Radiology Practice Phenotypes: Sedation, Clinical Integration, and Procedural Complexity in Medicare Claims Data, 2013-2023.
To define longitudinal practice phenotypes within the interventional radiology (interventional radiology) workforce using procedural sedation and evaluation and management (E/M) billing patterns and evaluate their association with procedural complexity and workforce growth.
A retrospective analysis of the Medicare Physician and Other Practitioners Public Use File was performed for 2013-2023.
physicians combining both bill for embolization far more often, signaling greater case complexity
The interventional radiology workforce increased from 1098 physicians (2013) to 2306 (2023).
Moderate sedation billing rose from 25% to 69%, markedly increasing after the 2017 Current Procedural Terminology restructuring.
Practice patterns diverged over time, with the "Moderate Sedation Only" group becoming the largest cohort (46.8% in 2023).
The "Moderate Sedation Only" group maintained a predominantly routine procedural profile.
The interventional radiology workforce is increasingly stratified into distinct practice phenotypes defined by procedural sedation and clinical integration.
Complex interventional radiology procedures are predominantly performed by physicians who combine both elements, whereas workforce growth is concentrated in procedurally focused physicians performing routine care.
Comprehensive interventional radiology practice, including participation in complex procedures, is most strongly associated with the combination of clinical integration and interventional radiology-directed procedural sedation.