Point-of-Care Ultrasound KEG

Hey all,

I have been trying to advocate with our hospital's admin team to buy us a POCUS Workflow software solution to allow us to save POCUS images so that we can start billing for it in our ICUs. I had initially given them a presentation taking about Professional and Technical charges etc and expected revenue generation from POCUS exams. Later I received a message from them stating that since July 1, payers are bundling ancillary services including bedside procedures into the room charge, so they do not expect POCUS will lead to any revenue generation. I highly doubt that POCUS would count as a 'bedside procedure' that would be considered a bundled ancillary service and I could not find anything to this effect online either. For the folks that work at places where you bill for POCUS exams - have you noticed any changes in the billing practices since July 1?

- Ankit Kushwaha

PCCM, Jackson TN

Most of us are still not billing for POCUS exams. Issue being documentation of the exam. Older machines do not have enough storage to save and upload the clips. 
I am not aware about any issues receiving a reimbursement for the exam 

Hey all,

I have been trying to advocate with our hospital's admin team to buy us a POCUS Workflow software solution to allow us to save POCUS images so that we can start billing for it in our ICUs. I had initially given them a presentation taking about Professional and Technical charges etc and expected revenue generation from POCUS exams. Later I received a message from them stating that since July 1, payers are bundling ancillary services including bedside procedures into the room charge, so they do not expect POCUS will lead to any revenue generation. I highly doubt that POCUS would count as a 'bedside procedure' that would be considered a bundled ancillary service and I could not find anything to this effect online either. For the folks that work at places where you bill for POCUS exams - have you noticed any changes in the billing practices since July 1?

- Ankit Kushwaha

PCCM, Jackson TN

This is likely a misinterpretation of some payors bundling "minor surgical procedures" with E/M code.

This would likely only apply to the facility fee and not the professional fee If it even applies to point of care ultrasound.

To my knowledge, we have not received any changes in reimbursement since this July, but it's a little early for all of that data to mature fully.

That being said, we typically only get about 40 to 50% reimbursement overall anyway. That's for all of our emergency medicine point of care ultrasound, though, so the payer mix for intensive care exclusively is probably different.

I personally decided that our group's policy would be to not compete with radiology ultrasound that was billed on the same day.

I very much disagree with the prior poster who thinks that most people in critical care don't bill for POCUS, Which I know to not be the truth. We also deserve to get paid for our work.

Be well,

Josh Davis, MD

Most of us are still not billing for POCUS exams. Issue being documentation of the exam. Older machines do not have enough storage to save and upload the clips. 
I am not aware about any issues receiving a reimbursement for the exam 

Hey all,

I have been trying to advocate with our hospital's admin team to buy us a POCUS Workflow software solution to allow us to save POCUS images so that we can start billing for it in our ICUs. I had initially given them a presentation taking about Professional and Technical charges etc and expected revenue generation from POCUS exams. Later I received a message from them stating that since July 1, payers are bundling ancillary services including bedside procedures into the room charge, so they do not expect POCUS will lead to any revenue generation. I highly doubt that POCUS would count as a 'bedside procedure' that would be considered a bundled ancillary service and I could not find anything to this effect online either. For the folks that work at places where you bill for POCUS exams - have you noticed any changes in the billing practices since July 1?

- Ankit Kushwaha

PCCM, Jackson TN

Thanks for the reply!

Biggest challenge billing for POCUS have been one: saving loops in patients chart, which clips and/or images do you upload  and save? and two: quality assurance, do you review the images and decision making inside your department or with other departments - cardiology, outside hospital groups/ departments? 

Thank you so much for your input! 

It has been a struggle 

Krassimir

This is likely a misinterpretation of some payors bundling "minor surgical procedures" with E/M code.

This would likely only apply to the facility fee and not the professional fee If it even applies to point of care ultrasound.

To my knowledge, we have not received any changes in reimbursement since this July, but it's a little early for all of that data to mature fully.

That being said, we typically only get about 40 to 50% reimbursement overall anyway. That's for all of our emergency medicine point of care ultrasound, though, so the payer mix for intensive care exclusively is probably different.

I personally decided that our group's policy would be to not compete with radiology ultrasound that was billed on the same day.

I very much disagree with the prior poster who thinks that most people in critical care don't bill for POCUS, Which I know to not be the truth. We also deserve to get paid for our work.

Be well,

Josh Davis, MD

Most of us are still not billing for POCUS exams. Issue being documentation of the exam. Older machines do not have enough storage to save and upload the clips. 
I am not aware about any issues receiving a reimbursement for the exam 

Hey all,

I have been trying to advocate with our hospital's admin team to buy us a POCUS Workflow software solution to allow us to save POCUS images so that we can start billing for it in our ICUs. I had initially given them a presentation taking about Professional and Technical charges etc and expected revenue generation from POCUS exams. Later I received a message from them stating that since July 1, payers are bundling ancillary services including bedside procedures into the room charge, so they do not expect POCUS will lead to any revenue generation. I highly doubt that POCUS would count as a 'bedside procedure' that would be considered a bundled ancillary service and I could not find anything to this effect online either. For the folks that work at places where you bill for POCUS exams - have you noticed any changes in the billing practices since July 1?

- Ankit Kushwaha

PCCM, Jackson TN

Hey all,

I have been trying to advocate with our hospital's admin team to buy us a POCUS Workflow software solution to allow us to save POCUS images so that we can start billing for it in our ICUs. I had initially given them a presentation taking about Professional and Technical charges etc and expected revenue generation from POCUS exams. Later I received a message from them stating that since July 1, payers are bundling ancillary services including bedside procedures into the room charge, so they do not expect POCUS will lead to any revenue generation. I highly doubt that POCUS would count as a 'bedside procedure' that would be considered a bundled ancillary service and I could not find anything to this effect online either. For the folks that work at places where you bill for POCUS exams - have you noticed any changes in the billing practices since July 1?

- Ankit Kushwaha

PCCM, Jackson TN