Reimbursement for CEUS Procedures Redesigned Demanded by ICUS

The International Contrast Ultrasound Society (ICUS) has made a significant move, requesting the Centers for Medicare and Medicaid Services (CMS) to reassign CPT Codes 76978 and 76979, which cover non-cardiac CEUS scans, to APC 5572 (Level 2 Imaging with Contrast).

CEUS, or Contrast-Enhanced Ultrasound, is a widely used imaging technique that allows for real-time assessment of blood flow. It has numerous applications, including characterizing tumors, stratifying a patient's risk of heart attack and stroke, monitoring chronic gastrointestinal diseases, and evaluating treatment efficacy.

The ICUS believes that the current reimbursement for non-cardiac CEUS does not accurately reflect its clinical and economic value. The society, in a letter from its board of directors, has made this request to the CMS.

CEUS offers several advantages over other imaging methods, such as contrast-enhanced CT and MRI procedures, which are already assigned to APC 5572. CEUS uses commercially available ultrasound contrast agents (UCAs) that are not nephrotoxic, do not contain iodine or gadolinium, and are suitable for patients with renal failure. Additionally, CEUS is more accessible to patients due to the wider availability of ultrasound systems in many medical centres compared to MRI or CT.

The reassignment of CEUS to APC 5572, as requested by the ICUS, would establish "clinical coherency that does not exist under the current APC assignment for CPT 76978." This change would better align reimbursement with the clinical and economic benefits of the procedure.

It is important to note that the ICUS's request does not apply to cardiac CEUS. The institution that announced in February 2025 to halt the revision of remuneration for certain contrast ultrasound examinations is not explicitly named in the provided search results.

The ICUS's advocacy for a change in the coding and reimbursement of non-cardiac CEUS could potentially lead to improved reimbursement for these procedures if accepted by the CMS. This change could have a significant impact on the accessibility and affordability of CEUS procedures for patients.