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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The ASNC is one of several medical imaging societies asking Congress to repeal the appropriate use criteria (AUC) criteria mandate. They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems. The AUC requirements call for documentation using CVMS authorized software in order to show advanced imaging such as nuclear and CT is justified, or else Medicare payments might be withheld.

American Society of Nuclear Cardiology urges Congress to speed prior authorizations, repeal AUC mandate 

Over the past few weeks, members of ASNC’s Health Policy Committee have held meetings with their members of Congress.

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Cardiology societies want to help Congress reform Medicare

Multiple cardiology societies, including the ACC, ASE and SCAI, want to work with Congress to update Medicare payment policies. 

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American Heart Association supports new ‘surprise billing’ legislation, but physician groups have serious doubts

According to the AHA, the No Surprises Act will "make a truly meaningful difference" to millions of patients. Physicians, on the other hand, have shared significant concerns about the legislation. 

money maze payment reimbursement

CMS finalizes 2022 Medicare Physician Fee Schedule—payments to cardiologists take a hit

Also, penalties for failing to comply with the Appropriate Use Criteria program have been delayed yet again. 

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High‐billing cardiologists order more tests when treating AFib—but outcomes do not improve

What do these findings say about current billing policies? 

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Cardiologists oppose 2 key CMS proposals, warn of ‘unintended consequences’

The American College of Cardiology has published a thorough analysis of the proposed 2022 Medicare Physician Fee Schedule, making many recommendations and comments related to the future of patient care. 

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Cardiologists urge CMS to reconsider MPFS changes that could ‘jeopardize the delivery of care’

The American College of Cardiology and Society for Cardiovascular Angiography (SCAI) and Interventions are just two of the medical societies concerned about this proposal. 

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Women in cardiology receive less money from CMS, submit fewer charges

More research is still needed to find out why these differences exist, but the authors did offer some possible explanations. 

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Around the web

Health Imaging
Use of AI opportunistic screening in CT for cardiovascular disease

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Health Imaging
New imaging protocols proposed to curb rise of cardiovascular infections

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.

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