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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CMS expanding coverage for CT lung cancer screening, drawing imaging advocate praise

ACR and the Society of Thoracic Surgeons said they will work with the feds, medical providers and patients to implement new screening recommendations.

What radiology providers need to know about 2022 CPT coding updates

The American Medical Association has added nearly 250 new Current Procedural Terminology codes this year, but only a select few impact imaging.

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Providers predict radiology practice closures if CMS fails to fix Medicare fee schedule

Payments for some office-based services are slated to fall 20%, potentially devastating private groups, experts said recently. 

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‘Grave concern’: Radiologist reimbursement expected to plummet after CMS clinical labor wage update

The Society of Interventional Radiology said the proposed cuts represent a “perfect storm,” resulting from the feds’ failure to keep labor rates and product tables current with inflation.

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American College of Radiology highlights imaging CPT code changes for 2022 and sooner

Two code additions for next year cover a new procedure—destruction of the intraosseous basivertebral nerve—that provides relief for certain back pain. 

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Radiologists ask Congress for $3B to offset looming cuts in Medicare Physician Fee Schedule

In a letter to lawmakers, 63 medical groups said the pandemic continues to challenge physician practices. 

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Radiologists demand greater transparency from CMS in Merit-Based Incentive Payment System

Docs are “particularly concerned” that the dearth of data could be concealing issues with cost measures or benchmarks, 45 physician groups including the ACR wrote recently.

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Prominent imaging groups push for first radiology-specific artificial intelligence CPT code

The Category 3 code proposal would cover AI analysis for the detection of vertebral fractures and could take effect as soon as Jan. 1, 2022. 

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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.