Start an Interventional Radiology Practice

1. 1

   Define the procedure mix and the setting

   Interventional radiology spans vascular work, embolizations (including uterine fibroid embolization), tumor ablations, biopsies, drainages, and dialysis access. Your case mix determines your equipment, your credentialing, and whether you belong in a hospital, an office-based lab (OBL), or an ambulatory surgery center (ASC). Choose deliberately, because an OBL doing venous and arterial work is a very different capital and compliance profile than hospital-based oncologic intervention.

2. 2

   Solve the imaging and procedure suite

   Image-guided procedures need fluoroscopy or angiography equipment, a sterile procedure room, radiation safety, and often ultrasound and CT guidance. This is expensive, which is why many IRs partner with a hospital or ASC that already owns the suite rather than building an OBL from scratch. Match the capital commitment to the case mix and volume you can realistically refer in.

3. 3

   Credential and cover the procedures

   You must be fellowship-trained and credentialed for each procedure at your facility, carry malpractice appropriate to procedural work, and meet radiation-safety and sterile-procedure standards. Procedural malpractice differs from diagnostic-read coverage. Confirm privileges and coverage before scheduling cases.

4. 4

   Build the referral engine

   IR volume comes from referrals: oncologists, vascular and general surgeons, OB-GYNs (for fibroids), nephrologists (for dialysis access), and primary care. Many patients do not know IR exists as an alternative to surgery, so referring-physician education and, where appropriate, direct patient marketing (for elective procedures like fibroid embolization) both drive volume. Referral relationships are the growth lever.

5. 5

   Bill procedures correctly

   IR reimbursement is procedure-based with its own CPT coding, moderate-sedation and device billing, and site-of-service differences between hospital, ASC, and OBL. Per-case revenue is higher than a diagnostic read, but so is cost and coding complexity, and denials are common. Use radiology and procedure-savvy billing so you capture the full technical, professional, and device components.

6. 6

   Note the distinction from diagnostic imaging

   This is a procedural practice, distinct from a diagnostic imaging center that only scans and reads. Many groups run both, but the interventional line has its own equipment, staffing, credentialing, and reimbursement and should be planned as its own business unit. If you only want to read images, that is a different, lower-capital model.

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