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.

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.
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.
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.
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.
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.

Foot ultrasound bested foot MRI on pooled sensitivity while lagging on specificity

MRI beats ultrasound at grading common foot injury, but tables turn for up-or-down diagnostics

Injuries of the plantar plate—the cluster of ligaments underneath the four smaller “knuckles” of the toes—are better assessed with MRI than with ultrasound scans.

Major teaching hospital finds half its on-call abdominal ultrasounds call utilization into question

The investigators encourage radiologists to consider the numbers and take steps to “reinforce their gatekeeper function” to help cut ultrasound overutilization.

VIDEO: The importance of the Physician Practice Information Survey and its impact on radiology reimbursements

Linda Wilgus, CPA, CMPE, executive director and chief financial officer of Northwest Radiology Network and a past president of the Radiology Business Management Association (RBMA), explains the importance of the Physician Practice Information Survey CMS in calculating radiology reimbursements.

New York cardiologist charged for alleged involvement in COVID-related fraud scheme

He was charged with three counts of healthcare fraud for an alleged scheme involving office visits that never occurred.

Cardiologist’s legal fight against fraud conviction may be heard by Supreme Court

Kentucky cardiologist Richard Paulus was first found guilty back in October 2016, but he was granted a new trial in 2021.

Imaging industry advocate slams feds’ failure to address PET coverage gap in recent ruling

The Society for Nuclear Medicine & Molecular Imaging expressed "strong opposition" following CMS' decision, arguing there is no evidence to support limiting pay for such scans.

American College of Radiology, patient advocacy groups urge feds to fix CTC coverage gap

ACR and others have submitted a formal national coverage determination request, asking the agency to address payment gaps for virtual colonoscopies.

District of Columbia DC congress capitol hill

CMS delays start of Radiation Oncology Alternative Payment Model yet again

The mandatory bundled payment initiative was slated to kick off Jan. 1, 2023, following numerous delays, but will now launch on a to-be-determined date.

Revenue & Reimbursement

ASNC lobbies Congress to curb prior authorization, oppose AUC mandates and embrace payment reform

CMS proposal includes cardiologist pay bump—cuts to high-value services still a concern

AMA very concerned 'Big, Beautiful Bill' will accelerate closure of more rural hospitals

Medicare now covers TriClip procedures for patients with symptomatic tricuspid regurgitation

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