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.

Physicians are now bracing for payment cuts after the Centers for Medicare and Medicaid Services (CMS) published its final rule for the 2023 Physician Fee Schedule.

Providers face ‘ominous reality’ of payment cuts as CMS finalizes 2023 Physician Fee Schedule

Physicians are now bracing for payment cuts after the Centers for Medicare and Medicaid Services (CMS) published its final rule for the 2023 Physician Fee Schedule.

November 2, 2022
Example of the four types of breast tissue density. The density of fibroglandular tissue inside the breast impacts the ability to easily see cancers. Cancers are very easy to spot in fatty breasts, but are almost impossible to find in extremely dense breasts. These examples show craniocaudal mammogram findings characterized as almost entirely fatty (far left), scattered areas of fibroglandular density (second from left), heterogeneously dense (second from right), and extremely dense (far right). RSNA

Breast density notification laws blanket 90% of U.S. women, yet still no national reporting standard is at hand. Why is that?

Dense breast experts Wendie Berg, MD, and JoAnn Pushkin, executive director of DenseBreast-info Inc., explain the current status of breast density patient inform laws, reimbursement and new technologies to aid cancer detection. 

October 6, 2022
Dhanunjaya "DJ" Lakkireddy, MD, executive medical director for the Kansas City Heart Rhythm Institute at HCA Midwest Health, professor of medicine at the University of Missouri, Columbia, deputy editor for the the Journal of Atrial Fibrillation, and serves on the HRS Board of Trustees and section steering committee chair for the ACC, explains the potentially devastating impact of Medicare cuts on electrophysiology (EP) and patient care.

VIDEO: Medicare cuts could devastate the field of electrophysiology

"By imposing a 35%-42% cut, [CMS] has essentially created a scenario where it is going to destroy electrophysiology as a field," explained Dhanunjaya "DJ" Lakkireddy, MD.

October 4, 2022
AMA analysis of Medicare Trustee data shows Medicare updates compared to inflation 2001-2021.

More than 100 medical societies push Congress to end destructive cycle of annual Medicare cuts

More than 120 medical societies have joined the AMA in a letter urging congressional leaders to enact long-term solutions to the systemic problems in the Medicare physician payment system and to address cuts that are going into effect in 2023.

September 26, 2022
Medicare money payment physician. The CardioVascular Coalition and Society for Cardiovascular Angiography and Interventions have both issued new statements highlighting their issues with the 2024 MPFS proposed rule. 

The fight continues: Cardiologists turn up heat on Congress to stop Medicare payment cuts

Dozens of medical societies have signed a new letter urging Congress to stop upcoming Medicare payment cuts. “The Medicare payment system remains on an unsustainable path threatening beneficiaries’ access to physicians," they wrote. 

September 23, 2022
medical billing_5.jpg

How would the proposed 2023 MPFS impact your cardiology practice? Use this free tool to find out

The American College of Cardiology has developed a helpful calculator that allows cardiologists and practice managers to estimate just how much the proposed 2023 MPFS could impact their practice.

August 11, 2022
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.

July 29, 2022
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. 

June 22, 2022

Around the web

The recall includes specific lots of five different medical devices used to treat stroke and other neurovascular diseases.

The agency is urging healthcare providers to transition away from these devices and seek out alternatives. It is even working with other manufacturers to try and get similar products on the market as quickly as possible. 

Jeffrey Kuvin, MD, one of the leading voices behind efforts to create a new Board of Cardiovascular Medicine, spoke with Cardiovascular Business about where things stand today.

Trimed Popup
Trimed Popup