Cost and revenue per scanner hour
The scarcest resource in radiology is scanner time on MRI and CT. What that time costs and what it earns is therefore the central metric: the contribution margin per scanner hour makes exam types comparable and shows which scan mix carries a scanner economically.
Cost of scanner time
Section titled “Cost of scanner time”We break costs down far enough that they can be attributed to a scanner’s occupied time:
- Equipment: depreciation or leasing, service and maintenance contracts, energy, helium or cooling
- Staff: radiographers, front desk and physician time, separated by the share that is tied to scanner time
- Room and infrastructure: rent, depreciation of building works, IT and the PACS share
- Consumables: contrast media, coil and material usage, attributed per exam
- Overheads: apportioned, with the allocation key made explicit
The result is an hourly rate per scanner and operating window – not an average across the whole practice. For slot planning the same rate is broken down to the minute on the scanner, because that is where single minutes make the difference.
Contribution margin per exam type
Section titled “Contribution margin per exam type”The cost of scanner time times the occupied time gives the cost side of an exam. Together with the revenue, this yields the contribution margin – per exam type and scanner, expressed per scanner hour. Because the occupied time varies, we do not treat the contribution margin as a single number but across the range of actual exam times (see scan durations).
This allows the scan mix to be planned and prioritised by its economic contribution. How that translates into slot templates and the case mix is described under economic scheduling.
Revenue mix and budget state
Section titled “Revenue mix and budget state”What an exam earns depends on where the revenue comes from. We look at three groups separately:
- Budget-bound EBM: services assigned to the standard service volume (Regelleistungsvolumen, RLV) and to qualification-based additional volumes (QZV). What matters here is not only the point value but the budget state: how far the volume is used up relative to progress through the quarter. Once it is exhausted, the marginal revenue of further exams in that group collapses – the service is still provided, but paid only at graduated or quota-based rates.
- Extrabudgetary EBM: services paid outside the budgeted volumes. Their marginal revenue stays stable across the quarter.
- GOÄ: privately insured patients and self-payers, independent of the volumes.
The same exam can therefore make a very different economic contribution at different points in the quarter. The budget state is consequently tracked continuously, not evaluated only when the fee statement arrives. Background on the volumes is covered in RLV and QZV explained.
Outcome
Section titled “Outcome”- Hourly rate for scanner time per scanner, with a traceable cost model
- Contribution margin comparison per scanner hour across exam types, scanners and sites, plus the revenue mix of budget-bound, extrabudgetary and GOÄ services
- Quarterly monitor for the budget state of RLV and QZV, with an eye on marginal revenue
- Scenarios, for example for changed slot lengths, operating hours, revenue mix or budget state
The calculation is a business planning tool and does not replace tax or billing advice.
Foundation
Section titled “Foundation”How these figures are derived from your own time, billing and cost data and checked for plausibility is described on cost and revenue per exam.