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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Medicare now covers non-invasive peripheral artery disease treatment

Medicare now covers a supervised exercise therapy for peripheral artery disease (PAD), according to CMS, a decision that will likely result in other insurers following this example.

Washington cardiologist settles overbilling allegations for $300,000

Romeo Pavlic, MD, a cardiologist from Spokane, Washington, agreed to pay $300,000 to settle a lawsuit alleging he overbilled Medicare and Medicaid patients, the Spokesman-Review reports.

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Coding for Clarity: Echocardiography Gains Two New CPT Add-On Codes

The approval of two new Current Procedural Terminology (CPT) codes acknowledges echocardiographic myocardial strain imaging and myocardial contrast perfusion echocardiography as emerging technologies, often a necessary step before a code is promoted to payable status.

Health system agrees to pay nearly $1 million for cardiologist’s alleged improper Medicare billing

A health system in Philadelphia agreed to pay nearly $1 million to resolve allegations that a cardiologist improperly billed Medicare for unnecessary services, Philadelphia Business Journal reports.

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Watch List? Comparative Billing Reports Alert Cardiologists to CMS Scrutiny

A year after Medicare issued comparative billing reports detailing transthoracic echocardiography usage, the physicians who received the reports still may have cause for concern.

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Waiting for Closure: Left Atrial Appendage Occlusion & Reimbursement Policy

Months after the U.S. FDA approved a device with the potential to close the source of many atrial fibrillation-related strokes, hospitals, cardiologists and patients find themselves in a holding pattern increasingly common for newly emerging therapies: They are waiting for the CMS to issue a national coverage determination for LAA occlusion.

Ohio cardiologist is sentenced to 20 years for overbilling

Harold Persaud, MD, a cardiologist from Ohio, was sentenced to 20 years in prison on Dec. 18 for overbilling Medicare and private insurance companies by $29 million between 2006 and 2012. The Department of Justice announced the sentence on Dec. 18.

Jury convicts Ohio cardiologist of overbilling Medicare by $7.2 million

A jury in Ohio convicted cardiologist Harold Persaud of performing unnecessary tests and procedures and overbilling Medicare and private insurers by $7.2 million.

Around the web

GE HealthCare said the price of iodine contrast increased by more than 200% between 2017 to 2023. Will new Chinese tariffs drive costs even higher?

Several key trends were evident at the Radiological Society of North America 2024 meeting, including new CT and MR technology and evolving adoption of artificial intelligence.