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.
