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Vascular

Currently vascular ultrasound 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). 

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 vascular ultrasound reimbursement.

Medicare communicates vascular ultrasound reimbursement 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:

  1. Click on Advanced Search
  2. Under Search by Document Type, check Local Coverage Documents
  3. Under What documents types do you want to search for? Check All Policies (LCD) and then Final Policies
  4. Select Geographic Area (State) AND/OR Contractor Criteria
  5. Type the testing area you are searching for (i.e., noninvasive vascular) or the LCD ID # into Enter Keyword(s) box and choose Title
  6. Click Search By Type box
  7. A page will appear asking you to accept the Terms & Conditions, Click Agree
  8. A new page will open with your search results

For additional reimbursement requirements refer to ICAVL’s website.

For state specific Medicare reimbursement information, click here.