The Changing Roles of Urologists, Radiologists, and Advanced Practice Providers in Uroradiology Procedures

Abstract

Study Need and Importance: Urology has seen shifts in the management of many urologic conditions with the advent of noninvasive procedures that rely on multidisciplinary radiological modalities. This study seeks to analyze changes in urologists, radiologists, and advanced practice providers (APPs) performing uroradiology procedures over time. What We Found: There were significant changes in all examined uroradiology procedures when examining procedure Medicare reimbursement distribution between urologists, radiologists, and APPs in 2010 to 2021 (P < .001; Table ). During the period, urology saw decreases in reimbursement proportion as large as 28.7% for kidney cryoablation and increases as large as 14.2% for nephrostomy tube removals. Radiology saw the largest decreases in reimbursement proportion with an 18.9% decrease for nephrostograms, while the largest increase was 23.6% for suprapubic tube placements. APPs saw the largest increase in suprapubic tube changes reimbursement proportion, which rose 14.2% from 2010 to 2021. There were also significant changes in proportion of Medicare procedure count in all uroradiology procedures, except for antegrade stent, renal cryoablation, renal biopsy, and renal thermoablation. Limitations: The data for the study only include Medicare beneficiaries and do not represent all uroradiology procedures. Additionally, these data do not provide the context in which APPs were involved with these procedures or their affiliated specialty. Lastly, the context of procedures cannot be extrapolated from the dataset.Interpretation for Patient Care: The provider type that performs uroradiology procedures has seen shifts for each examined procedure. Most large changes in reimbursement and procedure proportion were shifted between urology and radiology, with APPs seeing smaller changes. Management of many urologic conditions for patients subsequently may be influenced by who performs each procedure, with potential differences in outcomes, complications, and follow-up management.