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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Dana Smetherman, MD, ACR CEO, explains AUC may be better than prior authorizations.

ACR CEO discusses solution to fight burdensome prior authorizations in medical imaging

Dana Smetherman, MD, MBA, outlines a possible remedy for the growing number of these roadblocks in the specialty. 

CMS may double Medicare payments for cardiac CT

The agency is gathering feedback on a proposal to double the amount hospitals are paid for coronary computed tomography angiography, with the comment period ending Sept. 9.

Dana H. Smetherman, MD, MPH, MBA, FACR, the new CEO of the American College of Radiology (ACR), explains some of the hot button issues in radiology and advocacy efforts led by the ACR.

New ACR CEO outlines key concerns for radiology

Dana Smetherman, MD, MBA, explains some of the hot button issues in imaging and key advocacy efforts being undertaken by the college. 

Dana H. Smetherman, MD, MPH, MBA, FACR, the new CEO of the American College of Radiology (ACR), explains with the ongoing 2024 election, it is very unlikely there will be any serious reform to the Medicare payment system this year. She said further Medicare cuts set for 2025 also further threaten patient access to care.

Meaningful Medicare reform unlikely in 2024

New American College of Radiology CEO Dana Smetherman, MD, discusses the impact of reimbursement cuts, issues with staffing costs and prior authorization. 

How the proposed Medicare Physician Fee Schedule could impact nuclear cardiology

The American Society of Nuclear Cardiology explored some key points included in the 2025 Medicare Physician Fee Schedule proposed rule.

The ASNC team at the 2024 AMA meeting, Georgia Lawrence, JD, ASNC director of regulatory affairs; Suman Tandon, MD, FASNC, delegate to the AMA HOD and cardiac imager at NYU Langone; and Kathy Flood, ASNC CEO. #AMA #AMA24 #AMA2024 #AMAHOD #ASNC

ASNC supports AMA effort to limit use of AI in prior authorization decisions

The American Society of Nuclear Cardiology (ASNC) supports an AMA policy that condemns the use AI to make prior authorization decisions rather than a doctor or clinician.

Drawing inspiration from the World War II “Why We Fight” campaign that rallied support for the U.S. war effort, American Medical Association (AMA) President Jesse M. Ehrenfeld, MD, MPH, drew comparisons with the uphill battles physicians are facing today with dwindling reimbursements, physicians shortages, burnout and administrative fights against prior authorization burdens and attempts to preserve access to telehealth. #AMA #AMAHOD24 #AMAHOD2024 #HOD #HOD24 #HOD2024

AMA president calls for physicians to take war-time footing in fight over reimbursement, care quality

Drawing inspiration from the World War II “Why We Fight” campaign that rallied support for the U.S. war effort, AMA President Jesse  Ehrenfeld, MD, spoke on the uphill battles physicians are facing today.

AMA chart showing Medicare update payments compared to the cost of practice inflation between 2001-2024. The ongoing AMA PPI survey will be used top recalculate radiology practice expenses, but only 10 practices so far has submitted data that will impact all radiology practices.

Only 10 radiology practices completed survey used to adjust Medicare payments

The ACR shared its concerns about the lack of participation as the deadline approaches. 

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Around the web

Health Imaging
Nearly $800,000 settlement offered to family of man who died during MRI exam

The patient, who was being cared for in the ICU, was not accompanied or monitored by nursing staff during his exam, despite being sedated.

Cardiovascular Business
Global shortage of nuclear imaging isotopes may be over

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

Cardiovascular Business
‘A huge win’: CMS significantly increases Medicare payments for cardiac CT

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.