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.

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.
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.

Richard Heller, MD, RSNA Board member, associate chief medical officer for health policy and communications, and national director of pediatric radiology at Radiology Partners, explains some insurance companies are trying to take advantage of the No Surprises Billing Act by telling radiology practices they need to accept lower rates to remain part of the providers in-network.

Radiologists urged to report insurance companies forcing lower reimbursements due to No Surprises Act

Some payers are taking advantage of the NSA by forcing practices to accept lower rates to remain in-network, says Rad Partners' Richard Heller, MD.

Video interview with Radiology Business Management Association (RBMA) President Kit Crancer, and executive director of the Rayus Quality Institute, where he said the lack of federal policy on insurance coverage for diagnostic breast exams as opposed to screening exams

State legislation addresses gaps in breast imaging coverage, ensures affordable diagnostic exams

RBMA President Kit Crancer said a lack of federal policy has driven 20 states to adopt laws requiring that insurance cover the costs.

Video of Yousif Ahmad, MD, Yale, discussing IVL advances and increased reinbursements

Tracking key advances in intravascular lithotripsy

Yousif Ahmad, MD, spoke with Cardiovascular Business about the latest advances in IVL therapy, including new reimbursement changes for the technology.

Cardiologists make a familiar plea, urging Congress to eliminate impending Medicare cuts

Congress has already adjourned for the year without taking action, but U.S. medical societies are hoping relief from significant Medicare cuts will arrive in early 2024.

healthcare money economics dollar stethoscope acquire merger

Philips-owned BioTelemetry to pay nearly $15M for allegedly misleading clinicians to secure higher reimbursements

The company and one of its subsidiaries would allegedly confuse clinicians and have them bill government programs for cardiac monitoring services that were more expensive than what they needed. This settlement resolves those allegations.

Peter Moffatt, RBMA president-elect, discusses biggest issues facing radiology practices at RSNA 2023. #RBMA #RSNA #Radiology #CMScuts

Navigating the crucial challenges in radiology practice management

RBMA President-elect Pete Moffatt discusses how to contend with challenges such as staff shortages and reimbursement issues.

Video interview with Richard Heller, MD, RSNA Board member, associate chief medical officer for health policy and communications, and national director of pediatric radiology at Radiology Partners, explains the impact of the 2024 Medicare cuts on radiology and what comes next. #RSNA #RSNZA23 #RSNA2023 #CMS #Radiology

Putting US radiology reimbursement cuts in context and what comes next

Richard Heller, MD, a member of the RSNA Board and associate CMO for Rad Partners, explains the impact of the 2024 Medicare cuts and what is at stake.

money gavel court lawsuit legal judge judgement

Kentucky health system, cardiologist to pay $3M for alleged scheme targeting Medicare and Medicaid

The alleged scheme involved a series of diagnostic procedures that, according to the U.S. government, were not medically necessary.

Revenue & Reimbursement

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

SCAI highlights the benefits of ICE-guided structural heart interventions