作者: Brian P Triana , Tristan Chari , Dylan Muench , Roy Colglazier , Emily Vinson
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摘要: Purpose The financial sustainability of the US healthcare system is a growing concern in an environment of declining reimbursement and rising costs. Within Variable Centers for Medicare and Medicaid (CMS) reimbursement and denial rates for specific imaging examinations exist across sites of service, adding complexity to financial planning for healthcare organizations. Understanding the financial implications of site of service in existing CMS reimbursement for imaging may be of strategic importance for organizations going forward. Materials and Methods Current Procedural Terminology (CPT) codes were obtained for common cross-sectional imaging examinations using the 2022 CMS Medicare Physician Fee Schedule. Using reimbursement rates with historical volumes and denial rates, a simulation was created to estimate the overall reimbursement of paired hospital outpatient departments (HOPD) and free …