Given the recent explosion of research and development of novel targeted agents with improved specificity for delivery, we examined the providers administering radiopharmaceutical therapy (RPT) through analysis of U.S. Medicare payments. We further evaluated differences by specialties with respect to total distinct patients, total services billed, and average Medicare payment and submitted charge. This retrospective study queried the Provider Utilization & Payment Data prepared by the Centers for Medicare & Medicaid Services for 2020. The Healthcare Common Procedure Coding System (HCPCS) codes used for analysis comprised: Radioactive material therapy into vein; Infusion/instillation of radioelement solution; Radioactive material therapy into artery; and Lu 177 dotatate therapeutic. Provider specialties for which there existed at least 5 entries were included. Outcome measurements included provider gender, practice region, total distinct patients, total services billed, average submitted charge, and average standardized Medicare payment. Descriptive and nonparametric statistics (Kruskal-Wallis Test, Dunn's test) were calculated by specialty. A total of 171 providers were identified who billed for the above HCPCS codes within Diagnostic Radiology (DR) (n = 68, 39.8%), Nuclear Medicine (NM) (n = 59, 34.5%), Radiation Oncology (RO) (n = 24, 14.0%), and Interventional Radiology (IR) (n = 20, 11.7%). Geographically, 42.7% of providers were in the South, 23.4% in the West, 18.1% in the Midwest, and 15.8% in the Northeast. By gender, 21.1% identified as female, 78.9% as male. Descriptive statistics are summarized in Table 1. Total distinct patients was not significantly different across specialty (p = 0.872). Total services billed was significantly different for RO compared to IR (p<0.001), DR (p<0.001), and NM (p<0.001). There was no significant difference in average Medicare payment between RO and IR (p = 0.405), and between NM and DR (p = 0.063), though there was a significant difference in average submitted charge between NM and DR (p = 0.008). The results of this study highlight the opportunity for growth in radiation oncologists' utilization of RPT. Given the upcoming demand, it is pivotal to recognize the critical role radiation oncologists play in careful oncologic decision making, appropriate dosing and delivery of therapies by clinical scenario, and considerable follow up necessitated in patients receiving these novel therapies.