The latest blog post from Tyde Pavlinik: Interventional Cardiology Recognized by CMS


Medicare has officially recognized Interventional cardiologists. The Society for Cardiovascular Angiography and Interventions believes the decision will open up reimbursement opportunities and improve quality metric comparisons.

The designation entails a one-time request to the local Medicare provider. In this request the designation asks to be changed from general cardiology to the new C3 category. The whole process is quite straightforward and should only take about 15 minutes, according to SCAI.

One of the quickest acting changes this new change will bring will be that interventional cardiologists won’t have consultation claims denied for referrals from general cardiologists within the same physician group.

Peter L. Duffy, MD, MMM, and SCAI secretary has come out and said “Our electrophysiology colleagues are already in that situation. We’re doing the work, we’re just not getting paid for it.” Duffy work out of Reid Heart Center in Pinehurst, N.C. Duffy is also quoted in saying “hopefully it will carry through to them as well and they’ll be able to create their own separate designation and recognize the importance of separating us out from general cardiology, electrophysiology — if they have not done that already, from heart failure specialists, and from non-invasive, non-interventional cardiology.”

On the other hand, the organization’s push for this new change was not to get consults covered but instead because comparisons with general cardiology on quality metrics are not properly aligned.

As accountable care organizations evolve, the separate designation will be important as well.

“Right now general cardiology would be considered to be an included physician in an ACO model,” Duffy said. “If you admitted the patient to the hospital that patient would be attached to you. Even if they went to other hospitals and were out of your system, your ACO would still be responsible for any services that they received there. As interventionalists, we’re more designated to be doing specific procedures for patients … As excluded physicians from an ACO model, we would not be the designated primary care provider, which we shouldn’t be under that circumstance.”

via Tyde Pavlinik


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