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.

How radiology should prepare for AUC clinical decision support reporting requirements. CMS to require AUC CDS January 1, 2023.

How radiology should prepare for AUC clinical decision support reporting requirements

An overview for the coming January 2023 mandate to use clinical decision support for all advanced imaging orders.

May 10, 2022
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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.

April 25, 2022
The ASNC is one of several medical imaging societies asking Congress to repeal the appropriate use criteria (AUC) criteria mandate. They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems. The AUC requirements call for documentation using CVMS authorized software in order to show advanced imaging such as nuclear and CT is justified, or else Medicare payments might be withheld.

American Society of Nuclear Cardiology urges Congress to speed prior authorizations, repeal AUC mandate 

Over the past few weeks, members of ASNC’s Health Policy Committee have held meetings with their members of Congress.

April 18, 2022
CT scan showing lung cancer nodules with measurements of each nodule to track growth or regression from treatment. Image courtesy of RSNA

ACR outlines changes in Medicare lung cancer screening coverage

The American College of Radiology recently released a detailed summary of the National Coverage Determination related to screening for lung cancer with low dose CT.

February 28, 2022

For some docs, direct patient care + discounted rad services = freedom

A Florida primary-care physician who gave up the red tape of reimbursement for the hands-on of monthly retainer payments directly from patients—and for a single, discounted contract with a radiology practice—has gotten her story told in the local newspaper.

July 12, 2016

Hospitals get creative to up patient satisfaction

With $1 billion in payments on the line, hospitals are homing in on patient satisfaction. They are hiring chief patient satisfaction officers and patient navigators and tapping into volunteers to check on patient needs. Other strategies include “yacker trackers” to hush noisy nurses and yoga for patients and staff.

July 22, 2013

AMA makes it official—obesity epidemic is disease

The American Medical Association House of Delegates voted June 18 to recognize obesity as a disease. The move, which overrode recommendations of AMA’s Council on Science and Public Health, could open the door to improved reimbursement for treatment.

June 19, 2013

Duo debates $1B P4P dilemma

Two experts outlined the pros and cons of pay for performance in the Wall Street Journal. The article includes a chart placing radiologists at the top of specialist compensation. Meanwhile, noninvasive cardiology showed the highest growth in median compensation from 2002 to 2011.

June 17, 2013

Around the web

Automated AI-generated measurements combined with annotated CT images can improve treatment planning and help referring physicians and patients better understand their disease, explained Sarah Jane Rinehart, MD, director of cardiac imaging with Charleston Area Medical Center.

Two advanced algorithms—one for CAC scores and another for segmenting cardiac chamber volumes—outperformed radiologists when assessing low-dose chest CT scans. 

"Gen AI can help tackle repetitive tasks and provide insights into massive datasets, saving valuable time," Thomas Kurian, CEO of Google Cloud, said Tuesday. 

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