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.

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.
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.

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

CMS considers Medicare coverage options for tricuspid valve repair at Abbott’s request

CMS is now accepting public comments on this topic until Nov. 2. A final decision is expected by July 2025.

Monitoring acute heart patients at home linked to considerable cost savings

The new report could go on to help guide decisions made by CMS and hospital leadership teams for years to come.

Erin R. Stevens, CNMT, NCT, director of nuclear medicine at Oregon Heart Center, said training physicians for what is needed in cardiac PET documentation is key for preventing issues with prior authorizations. ASNC photo

Good documentation is the key to cardiac PET prior authorizations

Knowing what, exactly, is needed in cardiac PET documentation is one of the best ways to limit prior authorization issues.

Biden administration aims to improve prior authorizations for mental health services

Announced Monday, modifications to the Mental Health Parity and Addiction Equity Act would close loopholes that limit patient access to mental health and addiction treatments.

Time running out to comment on higher cardiac CT payments

Imaging experts have said the move could reshape the financial landscape for hospitals offering Cardiac CT services.

Medicare coverage for weight loss drug semaglutide could cost up to $145B per year

Medications that target obesity are not typically covered by Medicare. When the FDA approved semaglutide as a way to treat certain cardiovascular risks, however, CMS said Medicare coverage was on the table.

SCAI calls on interventional cardiologists to tell Washington to reverse physician pay cuts

Congress is considering two bills that would prevent or mitigate the Medicare physician payment cuts that went into effect in January 2024, and the Society for Cardiovascular Angiography and Interventions is urging members write their Congressmen.

CMS could increase CCTA payments—the American College of Cardiology wants to help

CMS wants feedback after proposing a significant update to CCTA reimbursement payments. The American College of Cardiology, a longtime champion for improved cardiac CT payments, is now helping its members make their voices heard.

Revenue & Reimbursement

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

How to get reimbursed for renal denervation

CMS considers Medicare coverage for TAVR in asymptomatic patients