Trends in Urodynamic Study Claims Billed by Physicians and Advanced Practice Providers in the United States between 2010 and 2024.

OBJECTIVE: To evaluate trends in urodynamic study claims submitted by physicians and advanced practice providers using two large administrative claims databases. METHODS: The MerativeTM MarketScan® database and Medicare Part B were queried for urodynamic study-related procedure codes from 2010-2024. Claims were stratified by patient age: <18, 18 to <65, and ≥65 years; United States Census region; and urbanicity. Outcomes included the number and proportion of claims billed by physicians and advanced practice providers and associated diagnosis codes. RESULTS: Urodynamic study claims declined from 359,099 in 2010 to 162,647 in 2024. In 2010, physicians accounted for 1602 (98.6%), 64,431 (99.3%), and 282,277 (96.5%) claims in the <18, between 18 and <65, and ≥65 year cohorts, respectively. In 2024, physicians accounted for 509 (76.7%), 17,115 (93.4%), and 129,735 (90.3%) claims in the <18, between 18 and <65, ≥65 year cohorts, respectively. Advanced practice provider-billed claims increased across all geographies and urbanicities, with the largest increase in the <18-year cohort between 2022-2023 (11.4% vs 23.5%). The distribution of diagnosis codes was similar between physicians and advanced practice providers in adult patients, but notably different in pediatric patients. CONCLUSION: Physicians continue to bill for most urodynamic studies; however, the proportion billed by advanced practice providers is increasing significantly, especially in the pediatric population. Further studies are needed to better understand the optimal role advanced practice providers play in performing urodynamic studies in modern urologic practice.