If you are performing Point of Care Ultrasound (POCUS) in your department and have an official review process (QA/QI), then you should really consider coding and billing for your ultrasound scans. This will require knowledge of the different ultrasound CPT codes and how much you may potentially bill and get reimbursed. Below I have tables with CPT codes listed and approximately reimbursement rates to get you started.
CPT® five-digit codes, nomenclature, and other data are Copyright American Medical Association. Ultrasound Reimbursement Rates are approximate and based on the National Average of the Medicare Physician Fee Schedule. (I can not guarantee the accuracy of all reimbursement rates, please double-check yourself if needed).
The Ultrasound CPT Codes and Reimbursement lists below are completely searchable and sortable by column to make it easier for you to find any Ultrasound CPT Code for 2021 or 2022. Whether you are billing for ultrasounds in the emergency department, clinic, office, outpatient, or inpatient settings we hope you find this helpful.
Definition of Professional versus Technical Fees/Payments For Ultrasound CPT Codes and Reimbursement
We hear “Professional” versus “Technical” fees and payments all of the time. It may seem confusing sometimes but it’s actually pretty simple. I want to go over the differences between them and some ultrasound coding guidelines before you start looking at the CPT code list.
Professional Fees or Payment of a charge covers the cost of the PHYSICIAN or PROVIDER’s professional services. Basically you are charging for your time and expertise for performing the ultrasound exam. For the most part, you should be able to bill for this, assuming you have a process to archive and QA/QI your scans. The Professional Fee/Payment will be received by your physician group directly.
The Technical Fees or Payment of a charge addresses the use of the equipment, facilities, non-physician medical staff, supplies, etc. Basically it is the fees for the equipment cost. Usually, this payment will go to the hospital or institution that purchased the ultrasound machines. Unfortunately, many institutions don’t realize the importance of billing for technical fees and only bill for professional fees. However, we’ve found in our practice that billing for technical fees is very important when it comes time to purchase new ultrasound machines. If you can show the hospital that you are generating revenue for them through technical fees it is much easier to get them to put new ultrasound machines in the budget!
Like this Post?
Sign Up For POCUS 101 Updates!
Point of Care Ultrasound (POCUS) CPT Codes List and Reimbursement Rates
These are the most common Point of Care Ultrasound (POCUS) CPT Codes and Reimbursement Rates for ultrasound billing. I put in the non-technical version of the study in the first column so it would be easier for you to use and browse through.
Point of Care Ultrasound (POCUS) Diagnostic Exam CPT Codes List
| Ultrasound Study | CPT Code | CPT Code Description | Professional Payment | Technical Payment | Total/Global Payment |
|---|
Point of Care Ultrasound (POCUS) Ultrasound-Guided Procedures CPT Codes List
| Ultrasound Study | CPT Code | CPT Code Description | Professional Payment | Technical Payment | Total/Global Payment |
|---|
Add-on CPT Codes for Ultrasound-Guided Procedures
| CPT CODE | CPT CODE DESCRIPTION |
|---|
Like this Post?
Sign Up For POCUS 101 Updates!
Cardiac Ultrasound and Echocardiogram/Echocardiography CPT Codes List and Reimbursement Rates
| CPT Code | CPT Code Descriptor | Professional Payment | Technical Payment | Total/Global Payment |
|---|
Pulmonary/Lung Ultrasound CPT Codes List and Reimbursement Rates
| CPT Code | CPT Code Descriptor | Professional Payment | Technical Payment | Total/Global Payment |
|---|
Obstetrics Ultrasound CPT Codes List and Reimbursement Rates
| CPT Code | CPT Code Descriptor | Professional Payment | Technical Payment | Total/Global Payment |
|---|
Gynecology Ultrasound CPT Codes List and Reimbursement Rates
| CPT Code | CPT Code Descriptor | Professional Payment | Technical Payment | Total/Global Payment |
|---|
Surgery Ultrasound CPT Codes List and Reimbursement Rates
| CPT Code | CPT Code Descriptor | Professional Payment | Technical Payment | Total/Global Payment |
|---|
Vascular Surgery Ultrasound CPT Codes List and Reimbursement Rates
| CPT Code | CPT Code Descriptor | Professional Payment | Technical Payment | Total/Global Payment |
|---|
