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.

The business of cardiology is changing—and cath labs are working to keep up
Financial literacy is no longer optional for physicians. “If you're not financially viable, you can't function,” explained Nirat Beohar, MD. “The business education is probably just as important as learning a new procedure.”
Aetna covers AI-powered coronary plaque assessments, joining other major insurers
This news follows similar announcements from Humana, Cigna and UnitedHealthcare; a majority of insured Americans can now be treated with these technologies and have the procedure covered by their provider.
Cardiology needs to evolve in the face of employment trends
Cardiology has largely shifted to hospital-employed models, driven by reimbursement compression and evolving physician priorities. This has created challenges as well as opportunities.
Radiology dominates FDA-cleared AI, but reimbursement lags far behind
As of January 2026, there will only be two CPT category 1 payment codes for newer AI, despite there being hundreds of FDA-cleared medical imaging algorithms.
How to get reimbursed for renal denervation
Herbert D. Aronow, MD, reviewed the many ways the reimbursement landscape is changing thanks to new Medicare policies. “This is a really exciting time in the renal denervation space," he said.

Nirat Beohar, MD, director, cardiac catheterization laboratory, medical director of the structural heart disease program, Mount Sinai Medical Center in Miami Beach, Florida, and a professor at the Columbia University Division of Cardiology, explains the financial landscape of the cath lab, what is ahead, and why cardiologists need to become more business savvy. #TCT

The business of cardiology is changing—and cath labs are working to keep up

Financial literacy is no longer optional for physicians. “If you're not financially viable, you can't function,” explained Nirat Beohar, MD. “The business education is probably just as important as learning a new procedure.”

Aetna covers AI-powered coronary plaque assessments, joining other major insurers

This news follows similar announcements from Humana, Cigna and UnitedHealthcare; a majority of insured Americans can now be treated with these technologies and have the procedure covered by their provider.

Herbert D. Aronow, MD, MPH, FACC, FSCAI, FSVM, medical director, heart and vascular service line and the Benson Ford Chair in Cardiology at Henry Ford Health, board member of the Society for Cardiovascular Angiography and Interventions (SCAI), explains the pros and cons and economic pressures involved with shifts in how cardiologists are now employment.

Cardiology needs to evolve in the face of employment trends

Cardiology has largely shifted to hospital-employed models, driven by reimbursement compression and evolving physician priorities. This has created challenges as well as opportunities.

Eric Rubin, MD, vice president of clinical operations at Virtua Health, and the American College of Radiology's CPT advisor to the American Medical Association (AMA), explains the process for creating a Category I CPT code for payments and the difference with Category III temporary tracking codes.

Radiology dominates FDA-cleared AI, but reimbursement lags far behind

As of January 2026, there will only be two CPT category 1 payment codes for newer AI, despite there being hundreds of FDA-cleared medical imaging algorithms.

How to get reimbursed for renal denervation

Herbert D. Aronow, MD, reviewed the many ways the reimbursement landscape is changing thanks to new Medicare policies. “This is a really exciting time in the renal denervation space," he said.

cardiologists going through the certification process

CMS considers Medicare coverage for TAVR in asymptomatic patients

After an official request from Edwards Lifesciences, CMS is rethinking its coverage policy for the use of TAVR to treat asymptomatic severe aortic stenosis. The agency is accepting public comments on this topic until Jan. 14.

Richard Heller, MD, MBA, FACR, senior vice president of health policy at Radiology Partners, and involved in policy advocacy with the American College of Radiology (ACR) and the Radiological Society of North America (RSNA), explains the key policy issues impacting radiology, including the CMS efficiency cuts and unfair policies by Anthem insurance.

Radiology policy shifts threaten patient access and physician sustainability

Radiology Partners' Richard Heller, MD, MBA, outlined several mounting policy pressures providers face heading into 2026.

Arnold Seto, MD, MPA, FACC, FSCAI, cath lab director, Long Beach VA Medical Center, professor of medicine at Charles Drew University, Society for Cardiovascular Angiography and Interventions (SCAI) treasurer and chair of the SCAI Advocacy Committee, explains changes in payment policy are making ambulatory surgical centers (ASC) and office based labs (OBL) more attractive to both cardiologists and larger health systems.

More interventional procedures may be coming to an ambulatory surgical center near you

ASCs have their limitations, but they are also associated with several benefits for cardiologists and patients alike.