Revenue & Reimbursement

Healthcare reimbursement is payment that a hospital, diagnostic imaging facility, subspecialty department or healthcare providers receive for performing a service. This also includes individual radiologist or cardiologist reimbursement and billing and coding rules for submitting claims.

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Erin R. Stevens, CNMT, NCT, director of nuclear medicine at Oregon Heart Center, said training physicians for what is needed in cardiac PET documentation is key for preventing issues with prior authorizations. ASNC photo

Good documentation is the key to cardiac PET prior authorizations

Knowing what, exactly, is needed in cardiac PET documentation is one of the best ways to limit prior authorization issues.

Time running out to comment on higher cardiac CT payments

Imaging experts have said the move could reshape the financial landscape for hospitals offering Cardiac CT services.

CMS could increase CCTA payments—the American College of Cardiology wants to help

CMS wants feedback after proposing a significant update to CCTA reimbursement payments. The American College of Cardiology, a longtime champion for improved cardiac CT payments, is now helping its members make their voices heard.

Dana Smetherman, MD, ACR CEO, explains AUC may be better than prior authorizations.

ACR CEO discusses solution to fight burdensome prior authorizations in medical imaging

Dana Smetherman, MD, MBA, outlines a possible remedy for the growing number of these roadblocks in the specialty. 

CMS may double Medicare payments for cardiac CT

The agency is gathering feedback on a proposal to double the amount hospitals are paid for coronary computed tomography angiography, with the comment period ending Sept. 9.

Dana H. Smetherman, MD, MPH, MBA, FACR, the new CEO of the American College of Radiology (ACR), explains some of the hot button issues in radiology and advocacy efforts led by the ACR.

New ACR CEO outlines key concerns for radiology

Dana Smetherman, MD, MBA, explains some of the hot button issues in imaging and key advocacy efforts being undertaken by the college. 

artificial intelligence AI heart cardiology

Cleerly’s AI software for noninvasive FFR estimates receives a Category 1 CPT code

The company officially launched its Cleerly ISCHEMIA software for delivering noninvasive evaluations of CCTA exams in early 2024. This update provides a closer look at the software from a billing perspective. 

Melissa Chen, MD, Clinical Neuroradiologist, Associate Professor, University of Texas MD Anderson Cancer Center, said challenges ton radiology include the limitations of the relative value units (RVUs) used to pay radiologists, the need for balancing workloads despite disincentives to reading some studies, and the need to find new workflow efficiencies with AI to offset the radiologist shortage. #RSNA

Radiology at tipping point with limitations of RVUs and the growing shortage of radiologists

Melissa Chen, MD, MD Anderson Cancer Center, outlines some of the challenges practices are facing and possible solutions.

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Around the web

Cardiovascular Business
Cardiology practices pay $17.7M to settle fraud allegations brought on by whistleblowers

A total of 16 cardiology practices from 12 states settled with the DOJ to resolve allegations they overbilled Medicare for imaging agents used to diagnose cardiovascular disease. 

Cardiovascular Business
Cardiology, radiology specialists debate CCTA’s rise as a go-to imaging modality for CAD

CCTA is being utilized more and more for the diagnosis and management of suspected coronary artery disease. An international group of specialists shared their perspective on this ongoing trend.

Cardiovascular Business
New AI program delivers rapid, accurate echo video assessments

The new technology shows early potential to make a significant impact on imaging workflows and patient care.