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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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. 

Video - Ken Rosenfield, MD, MGH, and William Gray, MD, Lankenau Heart, explain impact of new CMS coverage for carotid stenting.

How a big CMS update on carotid stenting could impact interventional cardiology

Ken Rosenfield, MD, of Massachusetts General Hospital, and William Gray, MD, of Lankenau Heart Institute, detailed the long-term impact of a key policy shift. 

Heart surgery prices vary from one part of the US to the next

Researchers explored the costs associated with CABG at more than 500 U.S. hospitals. 

Carrie Redick RN MSN NEA-BC, director of interventional cardiology and structural heart, Morristown Medical Center, Atlantic Health System, explains the need for financial literacy among structural heart program directors at the Transcatheter Cardiovascular therapeutics (TCT) 2023 meeting.

Why financial literacy is so important for structural heart program directors

Carrie Redick, an ICU nurse for nearly 20 years, said understanding more about financial data improved her ability to acquire funding and other resources for her program when necessary. 

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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. 

An example of cardiac MRI myocardial blood flow reserve (MBFR) imaging. Image courtesy of https://doi.org/10.3390/diagnostics10090679

Imaging group thrilled with new CPT codes for MBFR measurements

The Society for Cardiovascular Magnetic Resonance applauded two new CPT Category III codes for myocardial blood flow reserve (MBFR) assessments.

American Society of Nuclear Cardiology (ASNC) 2024 President Lawrence Phillips, MD, FASNC, director of nuclear cardiology and medical director for outpatient cardiology at NYU Langone Health, explains ASNC’s advocacy efforts for Medicare payments and reform.

ASNC president advocates for Medicare reimbursement reform

Lawrence Phillips, MD, president of the American Society of Nuclear Cardiology, said that U.S. physicians are growing more and more frustrated by Medicare policies.

HeartFlow’s AI-powered CAD offering receives new CPT code with improved reimbursement rate

For this update to be finalized, the American Medical Association had to determine FFRCT Analysis met certain requirements in terms of its overall impact on patient care. John Farquhar, CEO of HeartFlow, described the news as "a win for everyone involved, most notably patients." 

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.