Medicare doubles payment for certain contrast-enhanced ultrasound scans
November 26, 2025
Marty Stempniak | Radiology Business
Medicare is doubling reimbursement for certain contrast-enhanced ultrasound scans, drawing praise from the imaging industry.
The federal payment program for seniors revealed the update in its hospital outpatient final rule, published in the Federal Register Tuesday. Beginning Jan. 1, Medicare will increase payment for noncardiac, contrast-enhanced ultrasound from $170.02 to $358.35.
It’s also reassigning noncardiac CEUS imaging to the same billing code used for both contrast-enhanced CT and MRI (APC 5572, Level 2 Imaging with Contrast). The Centers for Medicare & Medicaid Services said this change “recognizes the specialized nature of contrast-enhanced ultrasound” while ensuring it receives “appropriate payment for these services.”
Industry advocates praised the decision. Earlier this year, the International Contrast Ultrasound Society had warned low reimbursement is keeping physicians from using the modality.
“Studies show that a simple, low-cost CEUS scan can offer sensitivity and specificity equivalent to that of CT and MRI,” Richard G. Barr, MD, a professor of radiology at Northeast Ohio Medical University and officer of the society, said in a Nov. 25 announcement. “They do not contain iodine or gadolinium and have not been shown have an effect on thyroid or renal function,” he added.
Contrast-enhanced ultrasound uses intravenously infused microbubble agents to enhance images, the society noted. This allows or visualization of abnormal microvascular blood flow patterns without exposing patients or providers to radiation. CEUS is utilized worldwide to characterize cancers, diagnose heart disease and monitor therapy. But its deployment in the U.S. has lagged due to low reimbursement, the society contends.
ICUS touted other benefits of the modality on Tuesday. Contrast CT or MR often are not options for patients with impaired kidneys due to nephrotoxicity or allergic reactions. Plus, contrast ultrasound can reduce healthcare costs by cutting the need for downstream tests and unnecessary interventional procedures. These scans also can be administered at the bedside, avoiding the need for transport to CT or MR.
“CEUS costs far less than contrast MR or CT, and it often does a better job,” Barr said in the announcement.
The society noted that three ultrasound contrast agents are commercially available in the U.S. These include Lumason from Bracco Imaging, Definity from Lantheus and Optison from GE HealthCare (all three companies are members of the society). However, only Lumason is currently approved by the U.S. Food and Drug Administration for noncardiac indications.
CMS to double CEUS payment with new code
November 25, 2025
staff writers
Under a newly-assigned billing code, the U.S. Centers for Medicare & Medicaid Services (CMS) will double payment for certain contrast-enhanced ultrasound (CEUS) imaging procedures.
The change, to go into effect January 1, 2026, will increase noncardiac CEUS reimbursement from $170.02 to $358.35.
It also reassigns noncardiac CEUS to the same billing code used for contrast-enhanced CT and MR procedures, APC 5572 (Level 2 Imaging with Contrast), according to the International Contrast Ultrasound Society (ICUS), which advocated for the reimbursement upgrade.
CEUS is used to help identify and characterize cancers, diagnose heart and vascular disease, monitor chronic gastrointestinal diseases, and monitor therapy, the ICUS explained.
In addition, CEUS is considered a suitable imaging option for patients who are pregnant or have impaired kidney or thyroid function, as the contrast agents do not contain iodine or gadolinium or expose the patient to ionizing radiation.
It is also less expensive than CT or MR imaging and can be administered bedside, reducing delays and offering reliable imaging for faster diagnosis, the ICUS added.
While three ultrasound contrast agents are commercially available in the U.S. — Lumason by Bracco Imaging, Definity from Lantheus, and GE Healthcare’s Optison — Lumason is the only ultrasound contrast agent approved for noncardiac indications by the U.S. Food and Drug Administration (FDA), according to the ICUS.
ICUS requests updated reimbursement for CEUS procedures
August 27, 2025
staff writers
The International Contrast Ultrasound Society (ICUS) has asked the Centers for Medicare and Medicaid Services (CMS) to update reimbursement for certain contrast-enhanced ultrasound (CEUS) imaging procedures.
In a letter submitted by its board of directors, the ICUS requested that the CMS reassign CPT Codes 76978 and 76979, which cover noncardiac CEUS scans, to APC 5572 (Level 2 Imaging with Contrast). The ICUS said that it is not seeking a change in reimbursement for cardiac CEUS.
The ICUS stated that contrast-enhanced CT and MRI procedures are already assigned to APC 5572; therefore, reassignment of CEUS would establish “clinical coherency that does not exist under the current APC assignment for CPT 76978.”
The ICUS said that its request for updated coding for non-cardiac CEUS is being made to align reimbursement with the clinical and economic benefits of the procedure.
CEUS is used worldwide to assess blood flow in real-time, allowing physicians to characterize tumors, stratify a patient’s risk of heart attack and stroke, monitor chronic gastrointestinal diseases and other conditions, and evaluate whether cancer therapies and other treatments are working, according to the ICUS.
CEUS uses commercially available ultrasound contrast agents (UCAs) that are administered intravenously, do not contain iodine or gadolinium, and are not nephrotoxic. The procedure is considered suitable for patients with renal failure for whom contrast-enhanced CT or MRI cannot be used. CEUS may also be appropriate for pregnant patients, as UCAs do not cross the placental barrier and because the procedure does not entail exposure to ionizing radiation or iodinated contrast.
Furthermore, ultrasound systems are more readily available in many medical centers than MRI or CT, making CEUS more accessible to patients, the ICUS noted.
Under-reimbursement keeping radiologists from using key imaging modality, docs warn CMS
August 27, 2025
Radiology Business
By Marty Stempniak
Under-reimbursement is keeping physicians from using a key imaging modality, docs warned the Centers for Medicare & Medicaid Services on Tuesday.
Their concern relates to low utilization of contrast-enhanced ultrasound in clinical scenarios other than cardiology. Such exams serve as a safe, cost-effective and radiation-free alternative to other imaging options. Yet, radiologists and other physicians are looking elsewhere due to inadequate payment.
To remedy this, the International Contrast Ultrasound Society is asking CMS to reassign two CPT codes—76978 and 76979, both covering noncardiac scans—from Level 1 to Level 2. This would bring CEUS into line with similarly contrast-enhanced MRI and CT exams, providing a “clinical coherency that does not exist” under current payment policy.
“Unfortunately, despite the very successful and widespread use of [contrast-enhanced ultrasound], … under-reimbursement in the United States may impede the appropriate use of CEUS … potentially to the detriment of patients,” Andrej Lyshchik, MD, PhD, with Thomas Jefferson University in Philadelphia, said in a statement from the society.
The radiologist, who also chairs the American College of Radiology’s LI-RADS CEUS Working Group, and colleagues recently wrote a letter to CMS about this issue. They’re urging agency Administrator Mehmet Oz, MD, and HHS to push for policy modifications related to sonography. The request to bump CEUS to Level 2 would increase reimbursement from $179.73 to $358.35, based on estimates provided by the society and derived from the proposed 2026 fee schedule.
This could help to spur greater use of the modality, which is already widely deployed in abdominal imaging across other countries. The International Contrast Ultrasound Society—sponsored by imaging agent manufacturers such as Bracco, GE HealthCare, Lantheus, Siemens Healthineers and Canon—hopes a Medicare policy change would spur reform across commercial plans, too.
They note that CEUS eliminates the need to transport patients to CT and MRI suites, avoiding delays and allowing for real-time diagnoses. Commercially available contrast agents are safe, they contend, and recommended by medical societies.
“Medicare coverage policy should use payment to favor use of cost-effective imaging and to take advantage of existing clinical guidelines,” members of the ICUS Board of Directors wrote to Dr. Oz. “Such an approach would give providers a financial incentive that is aligned with best-practice medicine.”
ICUS bills itself as a nonprofit medical society focused on the “safe and appropriate utilization” of CEUS. Alongside radiologists, its members include oncologists, hepatologists, cardiologists, nurses, sonographers and other professionals.
ICUS Urges CMS to Update CEUS Reimbursement, Citing Clinical Benefits for Patients and Healthcare Systems
August 26, 2025
Yahoo! Finance
CHICAGO, August 26, 2025–(BUSINESS WIRE)–The International Contrast Ultrasound Society (ICUS) today urged the Centers for Medicare and Medicaid Services (CMS) to update reimbursement for certain contrast-enhanced ultrasound (CEUS) imaging procedures, citing important clinical benefits for patients and healthcare systems.
“CEUS is a safe, cost-effective, noninvasive, radiation-free imaging modality” that often reduces the need for downstream testing and procedures, speeds up diagnosis, lowers overall imaging costs, streamlines workflows, improves patient outcomes and save lives – even in the sickest patients, according to a letter submitted to CMS by the ICUS Board of Directors.
The letter asks CMS to reassign CPT Code 76978 and CPT Code 76979, both covering non-cardiac CEUS scans, to APC 5572 (Level 2 Imaging with Contrast). ICUS is not seeking a change in reimbursement for cardiac CEUS.
CEUS is used worldwide to assess blood flow in real time, allowing physicians to pinpoint and characterize tumors throughout the body, stratify a patient’s risk of heart attack and stroke, monitor chronic gastro-intestinal diseases and other serious medical conditions, and evaluate whether cancer and other therapies are working.
CEUS utilizes commercially available ultrasound contrast agents (UCAs) that are administered intravenously during an ultrasound exam. UCAs do not contain iodine or gadolinium and are not nephrotoxic.
“UCAs are among the safest of all contrast media,” ICUS said.
“CEUS offers a dynamic and highly reliable method of imaging all soft tissue tumors in the abdomen and pelvis, in real time – with sensitivity and specificity comparable to and sometimes better than contrast-enhanced CT and MRI,” said Dr. Richard G. Barr, a professor of radiology at Northeast Ohio Medical University and an officer of ICUS. Dr. Barr also is editor-in-chief of the Journal of Ultrasound in Medicine.
ICUS stated that contrast-enhanced CT and MRI procedures are already signed to APC 5572, so reassignment of CEUS would establish “clinical coherency that does not exist under the current APC assignment for CPT 76978.”
ICUS said it is seeking updated coding for non-cardiac CEUS in order to align reimbursement with the proven clinical and economic benefits.
“Unfortunately, despite the very successful and widespread use of CEUS outside the United States, under-reimbursement in the United States may impede the appropriate use of CEUS, as described in clinical guidelines, potentially to the detriment of patients,” according to Dr. Andrej Lyshchik, a professor of radiology at Thomas Jefferson University in Philadelphia. Dr. Lyshchik currently chairs the ACR LI-RADS CEUS Working Group and is a member of both the LI-RADS Steering Committee and the board of directors of ICUS.
ICUS urges CMS to update CEUS reimbursement, citing clinical benefits for patients and healthcare systems
August 26, 2025
International Contrast Ultrasound Society (ICUS)
For Immediate Release
CHICAGO – Business Wire) The International Contrast Ultrasound Society (ICUS) today urged the Centers for Medicare and Medicaid Services (CMS) to update reimbursement for certain contrast-enhanced ultrasound (CEUS) imaging procedures, citing important clinical benefits for patients and healthcare systems.
“CEUS is a safe, cost-effective, noninvasive, radiation-free imaging modality” that often reduces the need for downstream testing and procedures, speeds up diagnosis, lowers overall imaging costs, streamlines workflows, improves patient outcomes and save lives – even in the sickest patients, according to a letter submitted to CMS by the ICUS Board of Directors.
The letter asks CMS to reassign CPT Code 76978 and CPT Code 76979, both covering non-cardiac CEUS scans, to APC 5572 (Level 2 Imaging with Contrast). ICUS is not seeking a change in reimbursement for cardiac CEUS.
CEUS is used worldwide to assess blood flow in real time, allowing physicians to pinpoint and characterize tumors throughout the body, stratify a patient’s risk of heart attack and stroke, monitor chronic gastro-intestinal diseases and other serious medical conditions, and evaluate whether cancer and other therapies are working.