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 reimbursement down 29% for cardiologists, 58% for heart surgeons

Physician payments are down slightly across the board, but they've fallen significantly for a handful of specialties. Researchers examined the long-term impact this trend could have on patient care.

Alison Bailey, MD, FACC, chief of cardiology, Centennial Heart at Parkridge Medical Center, and a physician director of cardiovascular disease for HCA Healthcare. She was the co-chair of a four-part series on the business of cardiology sessions at ACC 2024. She explains why ACC chose to concentrate on business. #ACC #ACC24 #ACC2024 #Cardiologybusiness

Why the business side of cardiology was a key focus at ACC.24

Alison Bailey, MD, co-chair of the business of cardiology sessions at ACC.24, emphasized that reimbursement cuts can have a long-term negative impact on patient. 

Video interview with ACC President Cathie Biga on goals for college over the next year and trends she saw at ACC 2024.

New ACC President Cathie Biga wants to improve quality reporting in cardiology

Biga, who originally trained as a nurse, specializes in the business side of cardiology. She also emphasized the increasing importance of AI and other new technologies. 

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New Jersey cardiologist faces up to 10 years in prison for $1.9M fraud scheme

The doctor, 76, admitted to billing multiple insurance providers for office visits that never happened at all.

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Cardiologist salary update: Compensation jumps to $525K per year, No. 3 among all specialties

In addition, cardiologists average an additional $75,000 per year in incentive-based bonuses. That number is only higher for two other specialties. 

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Critics call out ‘woefully inadequate’ CMS proposal for inpatient Medicare payments

CMS has issued its proposed rule for the 2025 Medicare hospital inpatient prospective payment system, suggesting a payment increase of 2.6%. According to the American Hospital Association, this update would not be enough at a time when hospitals are already struggling to stay open. 

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Cardiologists received $1.3B in industry payments over 10-year period, No. 3 among all healthcare specialties

Only orthopedic surgeons and neurologists/psychiatrists received more industry payments from 2013 to 2022 than cardiologists. Also, the two prescription medications associated with the most physician payments were a blood thinner and an anticoagulant. 

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ACC, SCAI say new funding bill did not do enough to limit Medicare reimbursement cuts to cardiology services

President Joe Biden signed a funding bill worth $460 billion on March 9, but it only included partial relief for cardiologists, cardiac surgeons and other cardiology professionals. 

Around the web

"Domestic radiopharmaceutical suppliers, who receive isotopes from abroad, would be impacted by price changes and uncertainty caused by additional tariffs,” SNMMI President Cathy Cutler, PhD, wrote in a letter to the U.S. Department of Commerce this week.

If President Trump initiates a 25% tariff against pharmaceuticals imported from Ireland, it might impact the price for X-ray iodine contrast agents in the U.S. depending what rules are put in place.