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What Is a CMR Reimbursement?

The past 20 years have brought about significant advances in the field of cardiovascular magnetic resonance (CMR). This technology allows doctors to gain substantial insight into a patient's heart-related health issues without the need for surgery. CMR is one of a handful of non-surgical diagnostic tools used to promote heart health, and while valuable, it may not often be the chosen diagnostic method due to reimbursement issues.

  1. CMR

    • CMR is a non-invasive cardiac imaging tool that produces highly detailed 2D and 3D images. No surgical procedure is required, and CMR produces detailed pictures of the heart while it is beating and at rest. Pictures can also be produced as moving images or still pictures. A contrast agent is sometimes injected into a patient to highlight certain blood vessels or portions of the heart for better image contrast and visibility. CMR is also known as cardiac magnetic resonance imaging (MRI).

    Diagnostic Tool

    • The CMR diagnostic tool is commonly used to evaluate diagnosed heart conditions such as damage from a heart attack, heart failure, pericarditis, heart valve problems, congenital heart defects and coronary heart disease. The CMR pictures allow for examination of the heart's structure and the ability to evaluate its function.

    Reimbursement

    • Financial reimbursement for CMR procedures by an insurance company or Medicare is a complex issue. Insurance companies and Medicare offer low reimbursements for CMR. Highly regulated environments in European countries allow only radiologists to perform CMR, which also makes this diagnostic tool less frequently used. Other diagnostic tools also offer more favorable reimbursement, causing doctors to choose them over CMR.

    Concerns

    • CMR competes with other technologies, such as cardiac computed tomography, as a tool for diagnosing heart issues. The competing technology and poor reimbursement for CMR explains why it has not been accepted more quickly by doctors. Additionally, CMR has the ability to acquire many markers of disease and other problems, which drives the cost of the test up. Some countries such as Greece do not use CMR much due to the lack of doctor training and agreement about the type of doctor that should administer the test and interpret the results. Future use of CMR will depend on insurance reimbursement improving and the costs dropping.

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