The effect of self-referral on utilization of advanced diagnostic imaging.

OBJECTIVE This article reviews the evidence on the relationship between recent increases in utilization of diagnostic imaging and self-referral. The evidence shows that self-referral invariably leads to higher utilization and the attendant higher costs. CONCLUSION Because most physicians do not own advanced imaging equipment, their own best interests are being thwarted by the practice of self-referral. Congress and the Centers for Medicare and Medicaid Services should restrict the in-office ancillary services exception to the Stark laws as it applies to advanced imaging.