Physician Self-referral - Economic Incentives

Economic Incentives

Self-referral has had the greatest influence on radiology. Normally, the revenue from imaging exams comes from two sources: the facility fee and the professional fee. The facility fee covers technical costs, such as use of the machine, while the professional fee is for the interpretation and consulting services provided by the physician. Physicians who own imaging machinery can derive profit by collecting both of these fees.

For example, when a patient is seen at a hospital and receives a CT scan, a technical fee is paid to the hospital to cover the cost of running the scanner, while the professional fee is charged by the radiologist for interpreting the results and documenting the findings. In self referral, however, a doctor seeing a patient in his office would recommend a test, often an echocardiography or nuclear cardiac imaging, that would be performed at his office and interpreted by him. Thus, the physician collects both the facility and professional fees.