Radiologists top list of physicians for highest out-of-network costs

Interventional radiologists charge nearly 6 times what Medicare pays out.

Many physicians charge more than what Medicare reimburses, but visits with certain physicians are more likely to result in large surprise medical bills, according to a national study by Johns Hopkins University.

The study was published Tuesday in the Journal of the American Medical Association. For the study, researchers examined the extent and variation of physician charges for uninsured patients and privately insured patients using out-of-network physicians. They used data from 429,273 individual physicians across 54 medical specialties. All physicians provided services to Medicare beneficiaries during the 2014 calendar year.

The study found that the average anesthesiologist charges for their services 5.8 times what Medicare reimburses. Following anesthesiology was interventional radiology (4.5), emergency medicine (4.0), pathology (4.0), neurosurgery (4.0) and diagnostic radiology (3.8).

On the other end of the spectrum, the study found physicians with the lowest markups include general practice physicians, psychiatrists, allergists, immunologists, dermatologists and family practitioners, according to Consumer Reports. All of these physicians charge less than twice the Medicare rates.

According to Consumer Reports, researchers also found regional differences; for instance, in Alaska and Wisconsin, physicians raise prices at almost twice the rate of physicians in Hawaii and Michigan, on average.

In response to the study, leaders with the American College of Emergency Physicians said too much focus is being put on physicians rather than insurance companies in talk about surprise billing.

“The letter in JAMA focused on all physicians, but insurance companies need to shoulder the blame for the out-of-network situation in emergency medicine, because they are narrowing their networks of medical providers, making it more likely that patients will be in out-of-network situations, and they continue to pay less,” Rebecca Parker, MD, president of the ACEP (American College of Emergency Physicians) said in a news release.

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