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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Supplemental breast imaging modalities of automated breast ultrasound (ABUS) and molecular imaging.

VIDEO: Use of supplemental imaging in women with dense breasts

Society of Breast Imaging (SBI) President John Lewin, MD, discusses the types of supplemental breast imaging used to aid cancer detection in women with dense breast tissue.

How to get paid, reimbursed, for cardiac CT, CTA CCTA. #SCCT #SCCT2022

VIDEO: How imagers get reimbursed for coronary CTA

Ahmad M. Slim, MD, associate professor of medicine with the University of Washington and regional chief medical officer with the Pulse Heart Institute, explained how imagers get paid for coronary computed tomography angiography (CCTA) exams.

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 They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems.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.

VIDEO: AMA will ask Congress to revise clinical decision support mandate for cardiac imaging

American Society of Nuclear Cardiology (ASNC) delegates to the American Medical Association (AMA) House of Delegates 2022 meeting Stephen Bloom, MD, and Nishant Shah, MD, explain a new AMA policy asking Congress to revise its clinician decision support mandate. 

Hospital finance

Collecting Earned Revenue: How AI Maximizes Radiology Payments

Sponsored by Infinx Healthcare

Today’s most pioneering radiology groups are using artificial intelligence to chase down payments, increase patient satisfaction, relieve front and back office workload, and recoup earned revenues.

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How radiology should prepare for AUC clinical decision support reporting requirements

An overview for the coming January 2023 mandate to use clinical decision support for all advanced imaging orders.

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FDA clears spinal-tap test that could challenge PET in Alzheimer’s diagnostics

The FDA has approved a lab test for evaluating cognitively impaired adults who may be in the early stages of Alzheimer’s disease.

Foot ultrasound bested foot MRI on pooled sensitivity while lagging on specificity

MRI beats ultrasound at grading common foot injury, but tables turn for up-or-down diagnostics

Injuries of the plantar plate—the cluster of ligaments underneath the four smaller “knuckles” of the toes—are better assessed with MRI than with ultrasound scans. 

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Major teaching hospital finds half its on-call abdominal ultrasounds call utilization into question

The investigators encourage radiologists to consider the numbers and take steps to “reinforce their gatekeeper function” to help cut ultrasound overutilization.

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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.