Reimbursement Comparison of Time-Based IR Billing vs. Traditional CPT Code Billing

Sunday, March 30, 2025

4:03 PM – 4:12 PM CT

Location: Music City Center, 201 AB

Presenting Author(s)

Joseph Reis, MD

Associate Professor
University of Washington, United States

Author/Co-author(s)

DF

Donya Forst, MS, RT

Interventional Radiology Supervisor
Seattle Children's, United States
AB

Aaron Bogart, MD

Assistant Professor
IR Seattle Childrens Hospital, United States
GS

Giri Shivaram, MD

Associate Professor
Seattle Children's Hospital, United States
RI

Ramesh Iyer, MD

Professor
Seatt, United States
KH

Keahi Higa, BS, MPH

Business Manager Imaging Sciences
Seattle Children's, United States

Purpose: Reimbursement for Interventional Radiology (IR) procedural supplies in the United States has historically been low, leading to lost revenue. Combining supply and facility costs may help to capture this revenue. This study compares reimbursement using a time-based billing model that bundles supply and facility costs to a traditional model that utilizes a Current Procedural Terminology (CPT) code for procedural facility costs and bills separately for supplies.

Materials and Methods:

A single center retrospective review of all IR cases from 2022 through 2024 was performed. Total case numbers were tabulated using accession number counts. The institutional billing method during this time transitioned from a traditional CPT code model during 2022-2023 to a time-based method during 2023-2024. Ten-minute case charge rates (CRs) were calculated from facility charges (FCs), average disposable supply charges (SCs), and average procedure time (PT) ([CR] = [FC + SC_avg]/[PT_avg]). Cases were then grouped into 7 categories based on average CR. Charge was determined by multiplying the average CR for each category by the actual procedure time. Net revenue and income generated in 2022-2023 were compared to 2023-2024.

Results:

2,644 procedures were performed in 2022-2023 (Oct-Sept) compared to 3,115 procedures in 2023-2024 (Oct-Sept). The average CR for charge categories fit an exponential regression model ([CR_avg] = $244.00 x e^{0.5 x [Category]}; R² = 0.99). Revenue in 2023-2024 using the time-based model was 30% higher overall and 12% higher per procedure compared to 2022-2023 using the traditional model. Income additionally increased 219% overall and 186% per procedure.

Conclusion: Time-based IR billing that bundles supply and facility charges improves reimbursement, resulting in higher earnings compared with traditional CPT based billing.