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.

Office-based interventional labs see boost in pay in 2026
CMS has made it a priority to increase payments for procedures performed by office-based labs and ambulatory surgical centers. This was reflected in policy changes made as part of the 2026 Medicare Physicians Fee Schedule.
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.

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.

The only heart failure treatment of its kind: Learn the latest billing recommendations for Barostim procedures

The Barostim device from CVRx continues to gain momentum as a go-to heart failure treatment. A free webinar is scheduled to examine the device's new CPT codes, which go into effect in 2026.

CMS to cover cardiac ablations performed in ASCs—cardiology group calls it a ‘tremendous victory’

Electrophysiologists can now perform cardiac ablation outside of a hospital setting. Groups such as the American College of Cardiology and Heart Rhythm Society have been pushing for this change for quite some time, pointing to the potential to cut costs and boost patient satisfaction.

At the recent American College of Cardiology (ACC) Legislative Committee meeting, leaders warned that ongoing federal policy uncertainty threatens patient access and the stability of cardiovascular care. Cathie Biga, MSM, immediate past president of the ACC, outlined growing concerns over telehealth, shrinking Medicare reimbursement, and mounting physician workforce shortages driven by visa restrictions.

ACC raises red flags over telehealth, payment reform and the cardiologist shortage

"We need telehealth the way we had it for COVID," Cathie Biga told Cardiovascular Business at TCT 2025. "We don't want to go back to having it so restricted."

ASE leading push to revise CPT code for interventional echocardiography

The pressure is on for ASE and other societies to create a new CPT code for the use of interventional echocardiography during structural heart procedures.

David Magid, MD, MPH/MSPH, a professor of cardiology at the University of Colorado, explains attributing cardiac patient care to physicians in accountable care organizations.

Common methods for attributing cardiac care in ACOs may be falling short

As the United States continues to move toward quality-based care, ACOs need to rethink the way they attribute care to cardiologists and other members of the heart team.

Lisa Miller, JD, former deputy assistant attorney general U.S. Department of Justice (DOJ) Criminal Division, a former principal assistant deputy chief of the DOJ healthcare fraud unit, and now a partner in the legal firm Sidley Austin LLP, explains what the DOJ is looking for in Medicare fraud cases.

What the DOJ looks for to spot healthcare fraud

Former principal assistant deputy chief of the U.S. Department of Justice's Healthcare Fraud Unit, Lisa Miller, explains what the DOJ is looking for in healthcare fraud cases.

SCAI highlights the benefits of ICE-guided structural heart interventions

ICE is gaining momentum as a helpful imaging option during structural heart interventions, according to a new SCAI position statement. TEE and TTE remain incredibly important, but there are times when ICE can provide the guidance necessary.

Revenue & Reimbursement

Office-based interventional labs see boost in pay in 2026

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

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

Cardiology needs to evolve in the face of employment trends

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