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CMS Doubles Payment for Contrast-Enhanced Ultrasound Scans

via Business Wire

Payment for certain contrast-enhanced ultrasound (CEUS) imaging procedures will double under a newly assigned billing code, according to an announcement by the International Contrast Ultrasound Society (ICUS) which advocated for the reimbursement upgrade.

The change, published in the Federal Register today and effective January 1, 2026, will increase non-cardiac CEUS reimbursement from $170.02 to $358.35.

It also reassigns non-cardiac CEUS to the same billing code used for contrast-enhanced computed tomography (CT) and magnetic resonance (MR) procedures – namely, APC 5572 (Level 2 Imaging with Contrast).

“This change recognizes the specialized nature of contrast-enhanced ultrasound technology and ensures appropriate payment for these services,” according to the final rule promulgated by the Centers for Medicare and Medicaid Services (CMS).

ICUS commended CMS for giving hospitals and physicians “a financial incentive that is aligned with best-practice medicine and recognizes the clinical and economic benefits of noninvasive CEUS imaging.”

CEUS scans use intravenously-infused microbubble contrast agents to enhance ultrasound images, allowing for visualization of abnormal microvascular blood flow patterns in real time without exposing patients or hospital staff to ionizing radiation.

CEUS is used worldwide to help identify and characterize cancers, diagnose heart and vascular disease, monitor chronic gastro-intestinal diseases and monitor therapy. However, its use in the US has lagged in part due to under-reimbursement, according to ICUS.

“Studies show that a simple, low-cost CEUS scan can offer sensitivity and specificity equivalent to that of CT and MRI,” according to Dr. Richard G. Barr, Professor of Radiology at Northeast Ohio Medical University and an officer of ICUS.

He said studies also consistently show that ultrasound contrast agents are among the safest of all contrast media.

“They do not contain iodine or gadolinium, and have not been shown have an effect on thyroid or renal function; in addition, CEUS is considered an ideal imaging option for pregnant patients because it avoids exposure to ionizing radiation and iodinated contrast media, and because ultrasound contrast agents do not cross the placental barrier,” Barr said.

In addition, contrast CT or MR are not options for many patients with impaired kidneys due to potential nephrotoxicity or allergic reactions to the CT or MR contrast agents, Barr added.

CEUS often reduces health care costs by reducing the need for more expensive downstream testing and unnecessary interventional procedures, according to Dr. Steven Feinstein, Co-President of ICUS.

Feinstein said that because CEUS may be administered at the bedside and offers a reliable diagnosis in real time, it can avoid the need to transport patients to a CT or MR imaging suite, reduce delays associated with CT and MR, streamline workflows, speed up the time to diagnosis, improve patient outcomes and save lives – even in the sickest patients.

“CEUS costs far less than contrast MR or CT, and it often does a better job,” Barr said.

Three ultrasound contrast agents are commercially available in the United States: Lumason (Bracco Imaging); Definity (Lantheus); and Optison (GE Healthcare). However, Lumason is the only ultrasound contrast agent approved non-cardiac indications by the U.S. Food and Drug Administration.

ABOUT ICUS:

The International Contrast Ultrasound Society (ICUS) is a nonprofit medical society dedicated to advancing the safe and medically appropriate use of contrast enhanced ultrasound (CEUS) to improve patient care. Membership in ICUS is free of charge and there is no fee for ICUS educational programs, CME credits, newsletters or other resources. To join ICUS and learn more about CEUS, visit www.icus-society.org and download ICUS CONNECT, the free ICUS mobile app.

Payment for certain contrast-enhanced ultrasound (CEUS) imaging procedures will double under a newly assigned billing code, according to an announcement by the International Contrast Ultrasound Society (ICUS) which advocated for the reimbursement upgrade.

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