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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doctor in handcuffs after being arrested

Cardiologist receives 35 months in prison for health insurance fraud

Fazal Panezai, MD, faced up to 10 years in prison for coordinating a years-long fraud scheme from 2017 to 2022. His New Jersey medical license has already been permanently revoked.

Abbott TriClip tricuspid edge-to-edge repair (T-TEER) device shown on transesophageal echo (TEE). The device clips together the leaflets of the valve to form a better seal and reduce regurgitation without the need for open heart surgery. Photo by Dave Fornell

Cardiology societies push Medicare to pay for tricuspid TEER

Six multispecialty cardiovascular societies have called on CMS to approve Medicare payments for tricuspid transcatheter edge-to-edge repair (T-TEER).

money maze benjamin franklin reimbursement medicare

Payment cuts and beyond: Key takeaways for cardiologists from the 2025 Medicare Physician Fee Schedule

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

Renal denervation systems from Recor Medical, Medtronic receive new outpatient payments

Both FDA-approved systems previously received inpatient payments in August. 

CMS updates outpatient reimbursement policy for Barostim device

CMS continues to show confidence in the benefits of baroreflex activation therapy with the Barostim device from CVRx. 

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CMS makes 2025 Medicare cuts official—and doctors are not happy

CMS has published its final rule for the 2025 Medicare Physician Fee Schedule, and it includes significant payment cuts. Cardiology groups have been working hard to stop these changes from going into effect since they were first proposed in July.

robot reviewing heart data

Medicare coverage expands again for AI-enabled coronary plaque assessments

Another MAC has agreed to cover the use of these advanced technologies to evaluate patients for signs of coronary artery disease. 

MGMA's Anders Gilberg discusses concerns on Medicare physician fee schedule

MGMA concerned by 2025 Medicare Physician Fee Schedule

The Medical Group Management Association (MGMA) Senior Vice of Government Affairs, Anders Gilberg, explains MGMA’s 28-page letter to CMS on issues with the proposed 2025 Medicare Physician Fee Schedule.
 

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