Cardiology marketing: screening offers, referrals

A cardiology practice markets to two audiences at once. Referring clinicians decide where many patients go, and patients themselves search for a cardiologist, a test or a symptom. Both channels come with rules that a general marketing plan does not account for: the physician self-referral law and the anti-kickback statute on the referral side, and FTC, FDA, Medicare and HIPAA rules on the patient side. A heart practice also has one obligation most specialties do not: some of the people reading its website may be having an emergency right now.

This guide covers each of those points with the primary source behind it, then lists marketing that works inside them. It does not cover clinical decisions, which belong to your physicians. For the general rules on promoting in-house testing to your own patients, see our guide to promoting in-office ancillary services. For reverse and readmission claims, see heart failure clinic marketing.

This is general information, not legal or medical advice. Sources cited were checked on October 29, 2026: the NHLBI page Heart Attack: Symptoms (last updated March 24, 2022); 42 U.S.C. 1395nn and 42 CFR 411.351 (physician self-referral law); 42 U.S.C. 1320a-7b(b) (anti-kickback statute); 42 U.S.C. 1320a-7a(a)(5) (beneficiary inducement); the US Preventive Services Task Force final recommendations on screening with electrocardiography (June 12, 2018) and on risk assessment with nontraditional risk factors (July 10, 2018); Medicare.gov, Cardiovascular disease screenings; 21 CFR 807.97; the FTC Health Products Compliance Guidance (December 2022); 16 CFR 255.2; 16 CFR Part 465; 45 CFR 164.508; and the Google Ads Healthcare and medicines and Personalized advertising policies. Have a health care attorney review your referral arrangements and marketing.

Every heart page needs an emergency line

The National Heart, Lung, and Blood Institute tells people to call 9-1-1 any time they think they might be having a heart attack, even if they are not sure. It also says an ambulance is the best and safest way to get to the hospital, and that people should not drive themselves or let someone else drive them. It notes that some people have mild symptoms, or none at all, and are still having a heart attack.

A practice website should never stand between a person with chest pain and that advice. In practice that means:

Condition and symptom pages. Pages about chest pain, palpitations, shortness of breath or heart attack should say near the top, in plain words, to call 9-1-1 for possible heart attack symptoms rather than book an appointment.
Contact forms and online booking. Add a short line above the form saying it is not monitored for emergencies and to call 9-1-1 instead. Nobody should wait for a callback about chest pain.
Phones after hours. Whether a person, an answering service or an AI receptionist answers, the first instruction for anything that sounds like an emergency should be to hang up and call 9-1-1. Our guide to the new patient phone script covers how to write that into the script.
Ads. Do not write ads that invite people with active symptoms to book a visit. Advertise appointments for evaluation and follow-up, not emergency care you do not provide.

Referrals: the self-referral law and in-office testing

Many cardiology practices perform tests in their own offices, and many receive patients from primary care clinicians. Both bring in the physician self-referral law, often called the Stark law. 42 U.S.C. 1395nn(a) says that if a physician, or an immediate family member, has a financial relationship with an entity, the physician may not refer Medicare patients to that entity for designated health services, and the entity may not bill for them, unless an exception applies.

Radiology and certain other imaging services are designated health services. 42 CFR 411.351 defines them by a published code list that includes diagnostic tests using x-rays, ultrasound, CT, MRI and, since January 1, 2007, nuclear medicine. Echocardiograms are ultrasound, and nuclear stress testing is nuclear medicine, so much in-office cardiac imaging can fall in scope. The definition excludes x-ray, fluoroscopy or ultrasound procedures that require inserting a needle, catheter, tube or probe, so check each service against the current code list rather than assuming.

Two marketing consequences follow:

Written notice for MRI, CT and PET. Practices that rely on the in-office ancillary services exception in 42 U.S.C. 1395nn(b)(2) for MRI, CT or PET, which includes cardiac CT and cardiac PET, must tell the patient in writing at the time of the referral that they may obtain the service elsewhere, with a written list of suppliers in the area where the patient lives. Promoting in-house imaging to patients does not replace that notice.
Gifts and perks for referring clinicians. The anti-kickback statute, 42 U.S.C. 1320a-7b(b), makes it a crime to knowingly and willfully offer or pay remuneration to induce referrals of items or services paid by federal health care programs. Free staff time, free tests for a referring office, paid advisory roles or discounted space need counsel’s review before they start.

Most practices compete for referrals on things that raise none of these questions: same-week appointments, clear consult notes sent back quickly, a direct line for referring offices and accurate listings. Our guide to patient and physician referrals covers how to build that, and our imaging center marketing guide covers the self-referral rules for imaging in more depth.

Heart screening offers: check them against the Task Force

Free or low-cost heart screenings are a common promotion. Before you run one, compare what you plan to offer with what the US Preventive Services Task Force says about it.

ECG screening. In its final recommendation of June 12, 2018, the Task Force recommends against screening with resting or exercise electrocardiography to prevent cardiovascular events in adults without symptoms who are at low risk (grade D). For adults without symptoms at intermediate or high risk, it found the evidence insufficient (an I statement).
Calcium scoring and other add-ons. In its final recommendation of July 10, 2018, the Task Force found the evidence insufficient to assess adding the ankle-brachial index, high-sensitivity C-reactive protein or a coronary artery calcium score to traditional risk assessment in adults without symptoms. The Task Force page notes that an update on coronary artery calcium scoring is in progress, so check it again before you publish.

None of this decides what your physicians recommend to an individual patient. It does matter for an ad aimed at the general public. The FTC Health Products Compliance Guidance says health claims need competent and reliable scientific evidence, and that advertisers are responsible for the net impression of an ad, including implied claims. An ad saying everyone over a certain age should get a heart scan implies a benefit for people the Task Force has not found it helps. Describe what the test is, who your physicians offer it to and what it can and cannot show.

Watch Medicare wording too. Medicare.gov says Part B covers cardiovascular disease screening once every 5 years, and that this includes blood tests for cholesterol, lipid and triglyceride levels; the patient pays nothing for the tests if the provider accepts assignment. That is a blood test benefit. Do not suggest Medicare covers a screening ECG or scan because it covers cardiovascular screening. And if a free screening event will include Medicare or Medicaid patients, remember 42 U.S.C. 1320a-7a(a)(5), which penalizes offering remuneration, including free or below-value services, that is likely to influence a beneficiary to choose a particular provider. Our guide to marketing to Medicare patients covers that rule.

If your practice runs a cardiac rehabilitation program or refers patients to one, the Medicare eligibility list, the physician’s role, the intensive program label and the dated window for video sessions at home are covered in our cardiac and pulmonary rehab marketing guide.

Devices: cleared is not approved

Cardiology uses many devices, from in-office monitors to wearables patients take home. Many reach the market through FDA’s 510(k) premarket notification process. 21 CFR 807.97 says a substantial equivalence determination does not in any way denote official approval of the device, and that any representation creating an impression of official approval because of complying with the premarket notification rules is misleading and constitutes misbranding.

So check each device’s FDA status before you describe it, say FDA cleared, not FDA approved, for a 510(k) device, and make the statement about the specific device you use, not the technology in general. Leave manufacturer brand names and performance claims out of practice marketing unless counsel has reviewed them; the claim becomes yours once it is on your page.

Patient stories, results and reviews

Heart patients often want to hear from someone who went through the same test or procedure. That is a reasonable thing to offer, with three rules in mind:

Authorization. If the practice is a HIPAA covered entity, using a patient’s story, photo or name in marketing generally needs the patient’s written authorization under 45 CFR 164.508. See our guide to HIPAA marketing rules.
Typical results. Under 16 CFR 255.2(b), an ad that presents one patient’s experience on a key point is likely to be read as what patients generally experience. Unless you can substantiate that, the ad should clearly disclose what patients can generally expect.
Reviews. 16 CFR Part 465 prohibits fake reviews and, in section 465.4, incentives conditioned on a review expressing a particular sentiment. Ask every patient for honest feedback, not only the happy ones.

Avoid outcome language altogether in general marketing. Words that promise a result, such as a guarantee that a procedure will prevent a heart attack, are claims the FTC expects you to substantiate, and cardiology outcomes depend on far more than the practice. Our guide to patient testimonials and before-and-after photos covers the rules in more detail.

Google Ads for a cardiology practice

Search ads suit cardiology well, because people search for a cardiologist near them, a specific test or a second opinion. Three Google policies shape the campaign:

Healthcare and medicines policy. Google restricts prescription drug terms in ads, landing pages and keywords, and some healthcare promotions require certification. A practice ad about appointments and tests normally does not need drug names at all, so leave them out of the ad and the landing page.
Personalized advertising policy. Health is a sensitive interest category. Google says advertisers promoting products and services in sensitive interest categories cannot use advertiser-curated audiences, such as remarketing lists. Build the campaign on search intent and location instead.
The landing page. Google’s healthcare policy applies to landing pages as well as ads. Send clicks to a page about the specific service, with the emergency line, real scheduling options and no tracking that sends health information to an ad platform. Our guide to landing pages for healthcare ads covers the build.

A marketing plan that works inside the rules

Illustration: an independent two-physician cardiology practice wants more new patients without any of the problems above. A plan in this order covers the basics.

Fix the website first. Add the 9-1-1 line to symptom pages, forms and booking, list every test and service you offer, and write plain pages explaining what each test involves and how to prepare, without drug or device brand names.
Serve referring offices. Publish a referral page with a direct number, fax and portal details, and how quickly you send consult notes back. Keep anything of value to referrers off the table unless counsel has approved it.
Keep listings accurate. One Google Business Profile per location, with correct hours, services and physicians, so both patients and referring offices find you. See our guide to Google Business Profile for doctors.
Run search ads on clear intent. Target searches for a cardiologist, specific tests and second opinions in your service area, with landing pages that match.
Ask for reviews the honest way. Ask every patient after a visit, without conditions or incentives tied to a positive review.
Review screening promotions. Check any screening offer against the Task Force recommendations and Medicare rules before it goes out.

Practices that run a blood thinner service, or refer patients to a pharmacist-run one, should read our guide to anticoagulation clinic marketing, which covers bleeding warning signs, collaborative practice agreements and home INR testing.

How we handle this

When we run Google Ads for a practice, we build campaigns on search intent and location, keep drug names and outcome promises out of ads and landing pages, and make sure every landing page tells people with possible heart attack symptoms to call 9-1-1. Our work is built with HIPAA in mind, and we confirm in writing what a BAA covers before any patient information flows through a tool; if it is not covered, we do not route patient information through it. See our Google Ads for practices service for how we approach campaigns.

Should a cardiology website tell people to call 9-1-1?

Yes, on any page where someone with symptoms might land. NHLBI says to call 9-1-1 any time you think you might be having a heart attack, even if you are not sure, and not to drive yourself to the hospital.

Can we advertise free ECG screenings to the public?

Be careful. The US Preventive Services Task Force recommends against ECG screening in adults without symptoms who are at low risk, and found the evidence insufficient for those at intermediate or high risk. An ad aimed at everyone implies a benefit the Task Force has not found, and the FTC holds advertisers to the net impression of the ad. Free services for Medicare or Medicaid patients also raise beneficiary inducement questions.

Does Medicare cover heart screening?

Medicare.gov says Part B covers cardiovascular disease screening blood tests for cholesterol, lipid and triglyceride levels once every 5 years, at no cost if the provider accepts assignment. Do not present that as coverage for a screening scan or ECG.

Can we say our heart monitor is FDA approved?

Not if it was cleared through a 510(k). 21 CFR 807.97 says clearance does not denote official approval and that implying approval is misbranding. Say FDA cleared, for the specific device.

Do the self-referral rules affect in-office echo and nuclear testing?

They can. 42 CFR 411.351 includes ultrasound and nuclear medicine in radiology and certain other imaging services, which are designated health services under 42 U.S.C. 1395nn. Have counsel confirm which exception your practice relies on.

Can we use remarketing for cardiology ads?

Google’s personalized advertising policy treats health as a sensitive interest category and does not allow advertiser-curated audiences, such as remarketing lists, when promoting services in that category. Use search intent and location instead.

Cardiology practice marketing: referrals, heart screening offers, device wording and emergency-safe pages