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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Critics call out ‘woefully inadequate’ CMS proposal for inpatient Medicare payments

CMS has issued its proposed rule for the 2025 Medicare hospital inpatient prospective payment system, suggesting a payment increase of 2.6%. According to the American Hospital Association, this update would not be enough at a time when hospitals are already struggling to stay open. 

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Former radiology group employees settle lawsuit over retirement benefits for $19M

About 180 former employees settled a suit with the former managers and owners of their radiology practice, saying their retirement benefits were mismanaged. 

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Cardiologists received $1.3B in industry payments over 10-year period, No. 3 among all healthcare specialties

Only orthopedic surgeons and neurologists/psychiatrists received more industry payments from 2013 to 2022 than cardiologists. Also, the two prescription medications associated with the most physician payments were a blood thinner and an anticoagulant. 

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ACC, SCAI say new funding bill did not do enough to limit Medicare reimbursement cuts to cardiology services

President Joe Biden signed a funding bill worth $460 billion on March 9, but it only included partial relief for cardiologists, cardiac surgeons and other cardiology professionals. 

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. 

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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.