STAT CT reads: under 4 hours, or 1 hour on request

A STAT CT read is an emergency CT interpretation delivered as a final signed report against a contractual deadline. At AstraRad that deadline is under 4 hours as standard, with 2-hour and 1-hour STAT available on request at a higher multiplier, measured from last-image arrival to radiologist signature. Every report is signed by a board-certified, fellowship-trained subspecialist licensed in the state where your patient is located, the test 42 CFR 482.22 applies to a distant-site physician whose reads reach a hospital's patients. The report your emergency physician acts on is the report of record.

Under 4 hours is the standard contractual tier your facility can enforce against us on every single study, and 2-hour or 1-hour STAT is available on request at a higher multiplier. The tier, together with its measurement rules, is published on our SLA page. A turnaround claim without a start point, an end point, and a measurement window leaves your facility comparing figures that measure different things. A published clock lets you hold us to it.

STAT CT reads run on one published clock

Every emergency CT scenario below rides the same clock: it starts when the last image of the study arrives and stops when the radiologist signs the final report. Stroke protocol studies carry a tighter commitment inside the STAT tier.

Stroke protocol studies are flagged at order and routed ahead of every other STAT read, which is what lets the 30-minute commitment hold while the general STAT tier stays at under 4 hours, with 2-hour and 1-hour STAT on request; both lines, and the clock they run on, are published on the SLA page. Scheduled work runs Routine at 24 to 48 hours. Your team selects the tier per study, and the full tier definitions are public. For how STAT reporting changes emergency department workflow, see STAT radiology reads.

Which CT protocols run STAT, and what does each one need from the reader?

Four presentations account for most emergency CT volume: suspected stroke, suspected pulmonary embolism, polytrauma, and the acute abdomen. The contractual tier is under 4 hours for pulmonary embolism, polytrauma, and the acute abdomen, with 2-hour and 1-hour STAT available on request at a higher multiplier, and stroke protocol studies carry a tighter commitment of under 30 minutes inside that tier. What differs is the fellowship the study routes to, the question the radiologist has to answer first, and what the ordering physician does with that answer. The ACR Appropriateness Criteria are the reference standard for which study belongs to which presentation, and they sit upstream of every protocol below.

Stroke protocol head CT

A non-contrast head CT in suspected acute stroke exists to answer one question before any other: is there intracranial hemorrhage. That answer gates thrombolysis, so it is the first thing the neuroradiologist reports and the first thing your emergency physician acts on. Early ischemic change is scored on the same series, and the CT angiogram of the head and neck follows to locate a large vessel occlusion and describe the collateral circulation, which is what a thrombectomy decision turns on. What the reader needs from your side is the time of symptom onset or last known well, because it changes the reading of everything else on the study.

CT pulmonary angiography for suspected pulmonary embolism

A CTPA answers two questions, and the second one is the one time pressure tends to shorten. The first is whether there is clot and where it sits: saddle, main pulmonary artery, lobar, segmental, or subsegmental. The second is whether the right heart is strained, which the chest radiologist reads from the right ventricle to left ventricle ratio, the interventricular septal configuration, and contrast reflux into the inferior vena cava. Risk stratification depends on that second answer, and so does whether the patient goes to a pulmonary embolism response pathway or to a ward bed. A study left non-diagnostic by contrast timing or respiratory motion has to be called just as fast, because your department needs to re-image or change approach while the clock is still early.

Trauma pan-scan

A whole-body trauma CT covers head, cervical spine, chest, abdomen, and pelvis, often with angiographic phases, and it lands as several series at once. The emergency and trauma reader sequences the report by consequence: active arterial extravasation, aortic injury, an unstable cervical spine, and an expanding hematoma go to the trauma team the moment they are seen, and the complete survey follows in the same signed report. A pan-scan is where final reporting earns its keep, because the small and incidental findings across five body regions in a polytrauma patient are exactly what a morning re-read would otherwise have to catch.

Acute abdomen

CT of the abdomen and pelvis in an acute presentation is a differential problem. Appendicitis, diverticulitis, small bowel obstruction, perforation with free intraperitoneal air, and mesenteric ischemia can all present as abdominal pain, and each one has a different next step. The body imaging subspecialist is separating the finding that sends the patient to an operating room tonight from the finding that admits them for observation. Prior imaging carries more weight here than anywhere else on the emergency list, because an interval change on a known lesion settles a question a single study cannot. A child's abdominal CT routes to pediatric radiology, where the dose context and the sense of normal anatomy are calibrated to children.

Two things hold across all four protocols. The reader opens the study with priors and clinical history already attached, and the result comes back as a final signed report carrying a name and a state license. Both apply at every tier, and neither is a STAT-only courtesy.

A matched subspecialist signs every STAT report

Each STAT CT routes to the panel member whose fellowship matches the clinical question: neuroradiology for stroke protocols and head trauma, chest radiology for PE studies, body imaging for the acute abdomen, cardiac imaging for coronary CTA, and pediatric radiology for children. Routing happens before interpretation begins, so no study waits for a reader who then hands it on. The radiologist opens your study with prior imaging and clinical history attached, the access the ACR Practice Parameter for Radiologist Coverage of Imaging Performed in Hospital Emergency Departments asks for before a final interpretive report on an emergency study, then dictates and signs under their own name and their own state license.

The panel is built of board-certified, fellowship-trained subspecialists, all physically located in the United States, which is where the Medicare Benefit Policy Manual requires the interpretation to be performed for Medicare to pay for it, and licensed in the state where your patients are located. Coverage runs 24/7/365 on scheduled shifts, so the neuroradiologist who picks up your 3 a.m. stroke protocol is in the middle of a staffed shift. Fatigue shows up in reports before it shows up anywhere else, and the shift structure exists to keep it out of yours. If overnight coverage is the specific problem your facility is solving, the nighthawk radiology page covers that model in depth.

A STAT study moves through six steps

Your technologist pushes DICOM from your PACS, or uploads through the secure portal, and flags the study STAT; the clock starts on arrival of the last image of the study. Routing assigns the study to an available matched subspecialist with priors and clinical history attached. The radiologist interprets, dictates, and signs the final report in one sitting; the difference between final and preliminary reporting matters enough that we wrote STAT vs preliminary vs final reads about it.

Findings that change immediate management are phoned to the ordering physician, and the call is documented in the report with the time and the person notified, which is the record the ACR Practice Parameter for Communication of Diagnostic Imaging Findings describes for nonroutine communications. The final signed report returns inside the SLA window as an HL7 ORU message or a FHIR DiagnosticReport, delivered into whatever RIS or EHR your facility already runs, or through the portal if that is simpler. Transfers are encrypted, and the platform is DICOM conformant and HIPAA aligned under a signed BAA.

There is no integration project in front of any of this. Most facilities send their first STAT study before formal integration work is even scheduled.

Critical findings on a STAT CT

A STAT CT is ordered because someone suspects a finding that changes management within the hour, so communicating that finding is part of the deliverable. The rule on our side is short. A finding that changes immediate management is phoned to the ordering physician or to the contact your facility designates, and the call is written into the final signed report with the time and the person notified. Report delivery is a separate event and never substitutes for the call.

What the full closed loop looks like at your facility is a larger policy question than one service page can settle: who acknowledges, what the escalation ladder is when the ordering physician has gone off shift, how long an unacknowledged notification may sit, and what the quality committee audits each month. Those belong in your own critical results policy, and the ACR practice parameter cited above is the standard most such policies are written against. What we commit to here is the first link in that chain, on the same clock as the report.

How fast is a STAT CT read, measured from what event?

A STAT CT read is contractually due in under 4 hours, or in 2 hours or 1 hour when you request the faster speed, and the clock starts when the last image of the study lands on our receiving node and stops when the radiologist applies a signature to the final report.

Nothing else starts or stops it. It does not start at radiologist assignment. It does not stop at a preliminary impression, and there is no preliminary impression to stop at.

Your emergency department runs a longer clock than ours, and the two should not be confused. The 2019 American Heart Association and American Stroke Association guideline for the early management of acute ischemic stroke indexes door-to-CT-interpretation targets measured from patient arrival, which include triage, transport, and acquisition alongside interpretation. Image arrival to signature is the segment we own inside that door-to-interpretation figure, and it is the only segment a teleradiology contract can hold anyone to.

A turnaround figure means whatever its measurement rules allow it to mean, so ours are fixed and published. SLA compliance is counted per study against the tier your facility selected, with every miss counted.

Accuracy is audited alongside speed. Our protocol pulls 1 in 20 final signed reports into an independent double-read by a second subspecialist, and each discrepancy is reviewed at the monthly discrepancy meeting and closed with the reader.

When you compare vendors, put three questions to every turnaround claim: where the clock starts, whether the delivered report is final, and over what period and volume the number was measured.

Per-report pricing applies to STAT CT reads

Your facility pays per final signed report, with no minimums, no subscriptions, no platform fees, and no annual commitment. Each faster STAT speed applies its own multiplier, printed on the rate card, so the cost of an emergency read is visible before your first study goes out. Industry pricing surveys put emergency CT interpretation across a wide range, driven mostly by contract minimums and after-hours premiums; those are industry-typical figures, and our teleradiology cost guide walks through them. The pricing page explains the per-report model in full.

One STAT tier covers every modality

The same STAT tier, panel, and SLA apply to every modality AstraRad reads: X-ray, mammography, ultrasound, CT including coronary CTA, MRI including cardiac protocols, nuclear medicine, and PET-CT. Emergency MR stroke protocols and acute ultrasound ride the same STAT lane as your CT volume. One limit belongs in plain sight: teleradiology cannot supervise contrast administration, perform CT-guided procedures, or staff any service that requires a physician in the room, so that portion of your coverage stays on site.

Under 4 hours is the standard promise your contract can enforce, with 2-hour and 1-hour STAT available on request at a higher multiplier. If your facility needs faster final reads on emergency CT, the useful evaluation is empirical. Request portal access through the contact page, send a study, and time the return against your current service: STAT CT reads either land inside the tier or they do not. STAT CT is one of four service lines; the full scope of what the panel reads is on our service lines page.