Currently echocardiography is NOT considered an advanced imaging modality and accreditation is NOT required by CMS under the new Medicare Improvements for Patients and Providers Act (MIPPA) that became effective on January 1st, 2012.
Although accreditation is not required through the new MIPPA act, there are several states in which the Medicare carrier and/or private insurers require either accreditation of the laboratory and/or sonographer credentialing, for echocardiography reimbursement.
Medicare communicates echocardiography payment policy primarily through contractor-specific Local Coverage Determinations (LCDs). These policies are changed and updated and for the most current information we recommend contacting Medicare directly. (These numbers are available through your hospital or laboratory’s billing department.)
You can also find Medicare payment policies at: www.cms.gov/mcd/overview.asp and follow these instructions:
For additional reimbursement requirements refer to ICAEL’s website.
For state specific Medicare reimbursement information, click here.
Always contact the insurance carriers in your area for the most accurate and current information.