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.

American Medical Association (AMA) Board of Trustees Member Scott Ferguson, MD, FACR, a diagnostic radiologist, discusses how and why physicians are opting out of Medicare because the payments no longer are covering their costs. Currently, the Centers for Medicare and Medicaid Services (CMS) say about 50,000 doctors have opted out of the Medicare program, or about 5% of U.S. physicians.

Why more physicians are opting out of medicare

American Medical Association (AMA) Board of Trustees Member Scott Ferguson, MD, FACR, discusses how and why physicians are opting out of Medicare because the payments no longer are covering their costs. 

Alan Matsumoto, MD, FSIR, FACR, FAHA, chairman of the American College of Radiology Board, professor of radiology and chair of the Department of Radiology, University of Virginia, Charlottesville, explains ACR support for the Texas Medical Association lawsuit three (TMA3) against the Department of Health and Human Service, because insurance companies are using the provisions of the law to to underpay providers for patient care.

ACR says insurance companies gaming the No Surprises Act with ghost rates

Alan Matsumoto, MD, chair of the American College of Radiology, discusses rad support for a Texas Medical Association lawsuit against the federal government. 
 

cardiologist Jason H. Rogers, MD, a professor at UC Davis Medical Center in Sacramento, California

Q&A: What Medicare covering TriClip means for heart patients with leaky tricuspid valves

The tricuspid valve has been at the center of several key policy shifts in recent years. In fact, Medicare now covers both T-TEER and TTVR when performed with FDA-approved devices. We spoke to interventional cardiologist Jason H. Rogers, MD, to learn more about how this momentum has impacted patient care. 

Interview with Alan Matsumoto, chair of American College of Radiology (ACR) Board, says Medicare physician payments are not sustainable, forcing many practices to consolidate with health systems or private equity owned companies.

ACR board chair discusses radiology's 'culture clash' between 'suits and white coats'

Alan Matsumoto, MD, explains the pros and cons of consolidation under hospital system and private equity ownership.

Alan Matsumoto, MD, chairman of Board for the American College of Radiology, explains Medicare cuts over the past 20 years lowered physician payments 33% and they can no longer cover expenses. The "Big Beautiful Bill" helps addressing this, but fails to make up decades of cuts to physician pay.

ACR says Medicare physician payments are unsustainable, urges congressional action

Alan Matsumoto, MD, chair of the American College of Radiology board, discusses how cuts over the past 20 years have lowered physician payments 33%. 

Suman Tandon, MD, FASNC, a cardiac imager at St. Francis Hospital and Heart Center, in Rosyln, New York, and an American Society of Nuclear Cardiology (ASNC) representative to the American Medical Association (AMA) House of Delegates (HOD), explains ASNC’s call on Congress for to reduce prior authorization, appropriate use mandates and to make Medicare payment reforms.

ASNC lobbies Congress to curb prior authorization, oppose AUC mandates and embrace payment reform

Suman Tandon, MD, an American Society of Nuclear Cardiology board member, explains the group's call on Congress to update a number of healthcare policies. 

dollar money graph increase finance

CMS proposal includes cardiologist pay bump—cuts to high-value services still a concern

The 2026 MPFS proposed rule includes higher conversion factors across the board. However, some cardiology groups remain concerned about a series of reimbursement reductions for high-value cardiology services. 

American Medical Association (AMA) Board of Trustees Member Scott Ferguson, MD, FACR, a diagnostic radiologist, explains the concern AMA has over the large number of rural hospitals closing and the shrinking access to medical care across large swaths of the U.S. He said the Big Beautiful Bill passed by Congress in July 2025 will likely accelerate closures.

AMA very concerned 'Big, Beautiful Bill' will accelerate closure of more rural hospitals

American Medical Association (AMA) Board of Trustees Member Scott Ferguson, MD, explains the concern that a large number of rural hospitals will close under the massive Medicaid cuts in the "Big, Beautiful Bill" passed by Congress in July 2025.