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.

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.
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.
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.
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.

Video - Ken Rosenfield, MD, MGH, and William Gray, MD, Lankenau Heart, explain impact of new CMS coverage for carotid stenting.

How a big CMS update on carotid stenting could impact interventional cardiology

Ken Rosenfield, MD, of Massachusetts General Hospital, and William Gray, MD, of Lankenau Heart Institute, detailed the long-term impact of a key policy shift.

Heart surgery prices vary from one part of the US to the next

Researchers explored the costs associated with CABG at more than 500 U.S. hospitals.

Carrie Redick RN MSN NEA-BC, director of interventional cardiology and structural heart, Morristown Medical Center, Atlantic Health System, explains the need for financial literacy among structural heart program directors at the Transcatheter Cardiovascular therapeutics (TCT) 2023 meeting.

Why financial literacy is so important for structural heart program directors

Carrie Redick, an ICU nurse for nearly 20 years, said understanding more about financial data improved her ability to acquire funding and other resources for her program when necessary.

artificial intelligence AI heart cardiology

Cleerly’s AI software for noninvasive FFR estimates receives a Category 1 CPT code

The company officially launched its Cleerly ISCHEMIA software for delivering noninvasive evaluations of CCTA exams in early 2024. This update provides a closer look at the software from a billing perspective.

An example of cardiac MRI myocardial blood flow reserve (MBFR) imaging. Image courtesy of https://doi.org/10.3390/diagnostics10090679

Imaging group thrilled with new CPT codes for MBFR measurements

The Society for Cardiovascular Magnetic Resonance applauded two new CPT Category III codes for myocardial blood flow reserve (MBFR) assessments.

American Society of Nuclear Cardiology (ASNC) 2024 President Lawrence Phillips, MD, FASNC, director of nuclear cardiology and medical director for outpatient cardiology at NYU Langone Health, explains ASNC’s advocacy efforts for Medicare payments and reform.

ASNC president advocates for Medicare reimbursement reform

Lawrence Phillips, MD, president of the American Society of Nuclear Cardiology, said that U.S. physicians are growing more and more frustrated by Medicare policies.

Melissa Chen, MD, Clinical Neuroradiologist, Associate Professor, University of Texas MD Anderson Cancer Center, said challenges ton radiology include the limitations of the relative value units (RVUs) used to pay radiologists, the need for balancing workloads despite disincentives to reading some studies, and the need to find new workflow efficiencies with AI to offset the radiologist shortage. #RSNA

Radiology at tipping point with limitations of RVUs and the growing shortage of radiologists

Melissa Chen, MD, MD Anderson Cancer Center, outlines some of the challenges practices are facing and possible solutions.

HeartFlow’s AI-powered CAD offering receives new CPT code with improved reimbursement rate

For this update to be finalized, the American Medical Association had to determine FFR_CTAnalysis met certain requirements in terms of its overall impact on patient care. John Farquhar, CEO of HeartFlow, described the news as "a win for everyone involved, most notably patients."

Revenue & Reimbursement

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

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

ASE leading push to revise CPT code for interventional echocardiography

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

What the DOJ looks for to spot healthcare fraud