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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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.  

An FDA panel will discuss its recommendations related to Abbott's TriClip G4 transcatheter edge-to-edge repair (TEER) system for tricuspid regurgitation.

Medicare now covers TriClip procedures for patients with symptomatic tricuspid regurgitation

CMS has finalized a new national coverage determination for T-TEER, sometimes known as transcatheter tricuspid valve repair. Abbott's TriClip is the only device approved by the FDA for T-TEER, but other treatment options are under development.

American Medical Association (AMA) Board of Trustees member Scott Ferguson, MD, FACR, a diagnostic radiologist in West Memphis, Arkansas, explains the urgent need for Medicare payment reform, concerns about Trump administration public health policy, insurance prior authorization, medical student immigration, and the rapid growth of private equity ownership of physicians.

AMA leader outlines major threats facing U.S. healthcare: Payment cuts, AI denials, immigration bottlenecks and corporate takeovers

American Medical Association Board Trustee Scott Ferguson, MD, FACR, a diagnostic radiologist, explains the urgent need for Medicare payment reform, concerns about Trump administration public health policy, insurance prior authorization, medical student immigration and the rapid growth of private equity ownership of physicians.  

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