Are you running a cardiology practice? If so, you cannot miss out on an important update coming from CMS's end, as they changed how coronary CT angiography codes are paid. CMS also added new G-codes for ASCVD risk assessment and management, impacting how you should bill and how much you would be reimbursed. It is always important for you to understand and apply these new rules accurately to avoid loss of revenue. It is true that a professional cardiology billing company can guide you through these changes and help you get paid the right amount, but still, you need to understand the changes to ensure a perfect billing cycle.
Understanding the Change: CCTA Codes Get a Boost
In the 2025 OPPS final rule, CMS temporarily moved CCTA codes 75572–75574 from APC 5571 to APC 5572, raising the payment from $175.06 in 2024 to $357.13 in 2025. This is a big increase, but you'll only benefit if you use the right cardiology revenue codes like 048x or 040x. If you keep using old codes like 035x or 032x, which show lower costs, you could lose money. Until 2023, hospitals had to use these general CT or radiology codes for CCTA. But cardiology groups argued that CCTA needs more resources, so CMS agreed to a change. They know it will take time—maybe 3 to 4 years—for hospitals to update billing systems. That's why the change is temporary for now. CMS will watch how many providers start using the correct cardiology codes. If enough do, they may keep the higher payment rate for good.
Now, you might be wondering how it matters for your billing process, right?
Know how these changes matter for your billing process
This is where things can get confusing — and why a cardiology billing company can really help. You'll need to update your charge master with the right cardiology revenue codes like 0489x or 0409x. Your staff must be trained on how to use these new codes correctly. Billing software and clearinghouse edits also need changes, so the system doesn't block the right codes. You'll have to check regularly to make sure everything follows CMS rules. All of this takes time and expertise. If you miss even one step, your claims could be denied, underpaid, or audited.
CMS also rolled out two new G-codes for ASCVD risk assessment and risk management services.
Know About the New ASCVD G-Codes
You should always assign G0537 for documenting ASCVD risk assessment in patients, and you should bill it once every year. You need to use G)538 for mapping patients who are at medium or high risk.
You must use a validated risk tool, document lab results properly, create electronic care plans, and get patient consent. A cardiology billing company makes sure you meet all these rules, so your billing is correct and you get paid without problems.
Hiring a professional cardiology billing company can make your life really convenient. It's time to know how they can help you.
How a Cardiology Billing Company Helps
They stay updated with all CMS changes and make sure your practice uses the right CCTA and ASCVD codes from the beginning. They help you avoid mistakes and make sure you don't lose money by using outdated or incorrect codes. Their team checks your revenue codes and updates them to match what CMS expects. They also help with software and system updates, working with your administrative team and EHR to fix billing edits so your claims don't get rejected. Billing companies also train your staff regularly, helping everyone from coders to front desk understand how and when to use the right codes. Even if you do everything right, some claims may still get denied. A billing company takes care of denials, resubmits claims, and handles appeals fast, so your payments aren't delayed and you don't lose revenue.
Now that you have realized how a professional cardiology billing company helps you, it's time to hire the perfect one to ensure a seamless RCM process.
SunKnowledge Inc. The Ideal Cardiology Billing Company
SunKnowledge Inc. is the ideal partner to handle all your cardiology billing needs. With end-to-end RCM services at just $7/hour, they offer unmatched value along with a free dedicated account manager and a smooth, no-cost transition period. Their team has deep billing expertise across 35+ specialties, including cardiology, making sure you always stay updated with the latest CMS rules and coding changes. With SunKnowledge by your side, you can focus on patient care while they ensure your revenue keeps flowing.