Evolving Use of fMRI in Medicare Beneficiaries

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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.

Table 1:

CPT Codes for fMRI

CPT Code	Description
70554	fMRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration
70555	fMRI; requiring physician or psychologist administration; this is to be always reported with CPT code 96020
96020	Neurofunctional 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

Table 2:

Site of service and specialty groups studied with the corresponding codes

Site Group/Specialty Group	Sites (Code)
Outpatient	Office (11), outpatient hospital (19 and 22), independent clinic (49)
Inpatient	Inpatient hospital (21)
Emergency department	Emergency department (23)
Other	Other: independent laboratory (81), skilled nursing facility (31), temporary lodging (16), mobile unit (15), home (12), and other place of service (99)
Radiology	Diagnostic radiology (30), interventional radiology (94), and nuclear medicine (36)
Neurology	Neurology (13)
Neurosurgery	Neurosurgery (14)
Others	All other identifiable groups
Unidentified	Unidentified: independent diagnostic testing facility (47), single or multispecialty clinic or group practice (70), unknown physician specialty (99)