Related Experiment Video
Updated: Oct 30, 2025
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
The direct costs of coronary CT angiography relative to contrast-enhanced thoracic CT: Time-driven activity-based
Michael E Zimmerman1, Juan C Batlle2, Cathleen Biga3
1Department of Radiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC 27710, USA.
Insights
The direct costs for Coronary CT angiography (CCTA) are significantly higher than contrast-enhanced thoracic CT (CECT). Current reimbursement rates may undervalue CCTA, potentially impacting patient access to this vital diagnostic procedure.
Area of Science:
- Radiology and Medical Imaging
- Health Economics
- Cost Analysis in Healthcare
Background:
- Coronary CT angiography (CCTA) and contrast-enhanced thoracic CT (CECT) are distinct chest CT procedures using intravenous contrast.
- The Centers for Medicare and Medicaid Services (CMS) currently reimburses the technical components of CCTA and CECT at the same rate.
- This study investigates potential disparities in the direct costs associated with performing CCTA versus CECT.
Purpose of the Study:
- To test the hypothesis that the direct costs of performing CCTA and CECT are significantly different.
- To compare the resource utilization and associated direct costs of CCTA and CECT procedures.
- To inform reimbursement policies by providing data on the actual costs of these imaging modalities.
Main Methods:
- A time-driven activity-based costing (TDABC) model was employed to measure direct costs.
- Procedures were segmented into preparation, scanning, post-scan monitoring, and image processing phases.
- Data on room occupancy, direct labor, and contrast material costs were collected from 54 patients across seven US medical facilities.
Main Results:
- CCTA procedures were 3.2 times longer (121 min) than CECT (37 min) (p < 0.01).
- Mean direct costs for CCTA were 3.4 times higher ($189.52) than CECT ($55.28) (p < 0.01).
- CCTA incurred significantly higher labor (6.5x) and capital equipment (1.8x) costs, with all procedural phases being more expensive (p < 0.01).
Conclusions:
- The direct cost of CCTA is substantially higher than CECT.
- Current reimbursement policies that equate CCTA and CECT costs may undervalue CCTA resources.
- This cost disparity could potentially limit patient access to CCTA services.
Background:
Coronary CT angiography (CCTA) and contrast-enhanced thoracic CT (CECT) are distinctly different diagnostic procedures that involve intravenous contrast-enhanced CT of the chest. The technical component of these procedures is reimbursed at the same rate by the Centers for Medicare and Medicaid Services (CMS). This study tests the hypothesis that the direct costs of performing these exams are significantly different.
Methods:
Direct costs for both procedures were measured using a time-driven activity-based costing (TDABC) model. The exams were segmented into four phases: preparation, scanning, post-scan monitoring, and image processing. Room occupancy and direct labor times were collected for scans of 54 patients (28 CCTA and 26 CECT studies), in seven medical facilities within the USA and used to impute labor and equipment cost. Contrast material costs were measured directly. Cost differences between the exams were analyzed for significance and variability.
Results:
Mean CCTA duration was 3.2 times longer than CECT (121 and 37 min, respectively. p < 0.01). Mean CCTA direct costs were 3.4 times those of CECT ($189.52 and $55.28, respectively, p < 0.01). Both labor and capital equipment costs for CCTA were significantly more expensive (6.5 and 1.8-fold greater, respectively, p < 0.001). Segmented by procedural phase, CCTA was both longer and more expensive for each (p < 0.01). Mean direct costs for CCTA exceeded the standard CMS technical reimbursement of $182.25 without accounting for indirect or overhead costs.
Conclusion:
The direct cost of performing CCTA is significantly higher than CECT, and thus reimbursement schedules that treat these procedures similarly undervalue the resources required to perform CCTA and possibly decrease access to the procedure.
More Related Videos
09:32Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
04:40Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:27Coronary Artery Disease V: Interprofessional Care