How teleradiology pricing works.

Per study vs per wRVU

The two common ways to price a read are per study and per work RVU.

Per study means a set price for each exam read. Some vendors use one flat price for every study; others set different prices by modality, so an X-ray costs less than a CT or an MRI. Per-study pricing is easy to understand and easy to check against an invoice: count the studies, multiply.

Per wRVU means the price follows the amount of physician work each study represents. A study that takes more radiologist work costs more; a simple one costs less. Your invoice depends on which studies you sent, not just how many.

Neither model is automatically better. A per-study price that looks low can be expensive if most of your volume is quick X-rays billed at a flat rate, and a per-wRVU price can be hard to forecast if you don’t know your mix. The useful question is which model matches the work your hospital actually sends.

What a wRVU is, and why case mix matters

RVU stands for relative value unit. In the Medicare Physician Fee Schedule, each procedure code carries RVUs for physician work, practice expense and malpractice. The work RVU, or wRVU, is the part that measures the physician’s time, skill and effort. Because it is published for every code, it gives buyers and vendors a shared yardstick for how much work a read takes.

In radiology the spread is wide. A single-view chest X-ray carries a small fraction of the work RVU of a CT of the abdomen and pelvis, and an MRI of the brain carries more again. That is what case mix means: the blend of modalities and exam types in your volume.

Picture two hospitals that each send the same number of studies in a month. One sends mostly ED X-rays; the other sends mostly CT. Under a flat per-study price they pay the same, even though the second sends far more radiologist work. Under per-wRVU pricing, the X-ray-heavy hospital pays less. Before comparing quotes, pull a few recent months of volume broken down by modality and hour, and ask each vendor to price that actual mix.

Monthly minimums

Many vendors set a monthly minimum. If your reads in a month add up to less than the minimum, you pay the minimum. Minimums exist because coverage has a fixed cost: a radiologist licensed in your state and privileged at your hospital has to be ready every hour you are covered, whether studies arrive or not.

Minimums matter most to smaller and rural hospitals, where a quiet month is common (see teleradiology for critical access hospitals). When you compare offers, ask what the minimum covers, whether it applies to every hour of coverage, and whether surcharges are added on top of it.

Surcharges and fees to look for

The rate on the first page of a quote is rarely the whole price. Some vendors charge extra for:

• STAT reads, which can matter a lot if much of your ED volume is ordered STAT.
• After-hours, weekend or holiday reads, sometimes as a premium on top of the base rate.
• Setup and interfaces, such as connecting orders and images.
• Credentialing, sometimes charged per radiologist.
• Preliminary-to-final conversions or overreads, where a prelim needs a final later. The difference between the two is explained in preliminary vs final reads.

Ask every vendor for a sample invoice built from your own volume, and ask what happens when a read is late. Some agreements charge for every read regardless of turnaround. Finally, read the term: how long it lasts, how it renews and how much notice you need to give.

How TeleRads prices

We price to remove the surprises listed above:

• One monthly price for the coverage you choose, so you can budget for the year.
• No STAT, after-hours or weekend surcharges. The hours you pick for coverage are the hours you pay for.
• Late reads aren’t charged. A read outside our turnaround isn’t billed.
• Setup is quoted up front and often waived.
• A one-year term, then 90 days’ notice after that.

Your exact price comes with your free coverage plan, built from your hours and volume. More on our model is on pricing, and what is included in every plan is on services.

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