Pain Management & Orthopedic Ultrasound

2014 MSK Ultrasound Reimbursement Changes

There's good news and bad news this year for MSK Ultrasound.  The bad news is reimbursement got cut, the good news is that it still is being paid around $100 for Medicare (depending on the locality).  Private insurers normally take 3-6 months to decrease their payments, so with that in mind we should notice a similar decrease to a range of $150-300 depending on the insurer.

Wait a minute, diagnostic MSK Ultrasound stayed relatively unchanged.  And you can perform and get paid for both an injection and diagnostic ultrasound within the same office visit.  So here's some simple math:

Shoulder Injection - 20610 - $50
Ultrasound Guidance - 76942 - $100
Diagnostic Ultrasound - 76881 - $120
Total Reimbursement = $270

Sure beats just getting paid $50 for the injection if you don't have ultrasound.  In addition, the Glenohumeral Joint is documented to have approx a 50% success rate done blindly, versus 98% rate done under ultrasound.  In addition, you just potentially saved the patient from having to schedule and pay for an MRI of their shoulder.  And that's something the insurance companies & patients alike can cheer for.

Another bit of good news, there has been no bundling for ultrasound guided procedures.  Unlike our friend, fluoroscopy.

So the bottom line is that ultrasound still makes very good business sense to add it to a private practice.  The decrease in reimbursement's is noticed around all facet's of your practice and unfortunately ultrasound isn't exempt from that.  However, there's a saying I'm reminded of for people that are paralyzed by fear in moving their practice forward "if you aren't moving forward, you are moving backwards.  There's no such thing as standing still".  This is true for businesses, and yes, your private practice is a business.

So move it forward.

For more information visit our Facebook page at

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Or contact me directly if you want to purchase ultrasound that includes expert setup & training for you and your office.

Paul Kapenga
815.213.3648
paulk@advisormedical.com