SCCT hopes to increase cardiac CT reimbursements through advocacy

 

Since its founding in 2005, the Society of Cardiovascular Computed Tomography (SCCT) has concentrated most of its efforts on advocating for more clinical coronary CT angiography (CCTA) studies to gather the needed data to support the wider use of cardiac CT in clinical practice. That clinical evidence is one of the reasons why CCTA was raised to a Class 1A level of evidence for front-line use in the ACC/AHA 2021 Chest Pain Guidelines

Those guidelines have now spurred a lot more interest in starting CCTA programs or expanding existing ones. But another hurdle for wider adoption is reimbursement for the scans. For this reason, SCCT has recently shifted more of its attention to advocacy and reimbursement issues. 

Mark Rabbat, MD, chairman of the SCCT Advocacy Committee, director of cardiac CT and professor of radiology at Loyola University Medical Center, spoke with Cardiovascular Business about these efforts at the society's 2023 annual meeting.

"There's been a lot of effort both to engage CMS, as well as Congress, on trying to increase the reimbursement for cardiac CT service. Right now, the current landscape is such that hospitals are disincentivized to perform this study. And ultimately what we want to do is improve access to cardiac CT for our patients that we serve," he said.

Earlier this year, the society hired a lobby firm in Washington, D.C., to put cardiac CT imaging issues in front of Congress.  

"We're now collaborating with a global law firm and we've actually conducted multiple congressional meetings. Recently, we've established a house appropriations bill whereby 23 congressional signatures were on this letter urging CMS to level the playing field and increase reimbursement for our services," Rabbat explained

SCCT is also asking its members to help with advocacy efforts by writing letters to their legislators on various CMS funding issues.

"There are a lot of exciting efforts that we're undertaking, and it really takes a village," he said.

Rabbat said some of those efforts include expanding access for cardiac CT by increasing funding to incentivize its use. He said they are also trying to change the ambulatory payment classifications (APCs), which are payments made for items and services furnished by hospital outpatient departments, to a cardiac diagnostic APC. He said that would be more in line with the services that cardiac CT provides. 

"We know that cardiac CT has had fantastic diagnostic performance as well as its prognostication. And we know that cardiac CT reduces poor clinical outcomes for our patients. So we're just trying to educate our congressional legislators on the topic, on the issue and the importance at a public health perspective," Rabbat explained. 

SCCT is trying to be creative with its strategy regarding potential revenue code changes. Right now, cardiac CT falls under general CT revenue codes, which brings down the cost of the procedure. So one thought is to perhaps change the revenue code to more of a cardiology-specific code as this could translate into more fair reimbursements to cover the cost of the services.

Dave Fornell is a digital editor with Cardiovascular Business and Radiology Business magazines. He has been covering healthcare for more than 16 years.

Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com

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