New Findings from Columbia University Irving Medical Center in the Area of Managed Care Described [Impact of 2023 Centers for Medicare and Medicaid Services (CMS) Guidelines on Point-of-Care Emergency Ultrasound Billing]: Managed Care

2025 DEC 09 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Managed Care have been published. According to news originating from New York City, New York, by NewsRx correspondents, research stated, “The 2023 Centers for Medicare and Medicaid Services (CMS) billing guidelines allowed a refocus on medical decision-making, the risk of morbidity, and overall medical complexity. It is uncertain how point-of-care ultrasound (POCUS) billing has been affected by these changes.”

Our news journalists obtained a quote from the research from Columbia University Irving Medical Center, “Elucidation of how 2023 CMS changes to POCUS billing can allow us to ensure alignment with best practices. To investigate the effect of the 2023 CMS changes on POCUS billing. This was a retrospective cohort study performed at a large urban quaternary care center. The baseline characteristics of patients and volume of documented POCUS, as well as by Current Procedural Terminology (CPT) codes and reimbursement rates in 2022 and 2023, were compared. We also evaluated the proportion of charts in which POCUS was incorporated into medical decision-making in 2 months in 2023. In total, there were 2900 and 2778 patient encounters with at least one POCUS documentation in 2022 and 2023, respectively. There was no difference in the volume of POCUS billed monthly, or CPT codes of billed POCUS between 2022 and 2023 (p = 0.47 and 0.90, respectively). Reimbursement rates for separately billed POCUS procedures remained unchanged, with an exception to private insurance, where reimbursement rate increased slightly (p = 0.011). There was a small proportion of visits (4.1%) in which POCUS billing affected the evaluation and management code for the emergency department visit.”

According to the news editors, the research concluded: “The 2023 CMS changes to billing have not significantly changed billing practices for POCUS.”

This research has been peer-reviewed.

For more information on this research see: Impact of 2023 Centers for Medicare and Medicaid Services (CMS) Guidelines on Point-of-Care Emergency Ultrasound Billing. The Journal of Emergency Medicine, 2025;80:145-151. The Journal of Emergency Medicine can be contacted at: Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA.

The news correspondents report that additional information may be obtained from Emily Cen, Dept. of Emergency Medicine, Columbia University Irving Medical Center, New York, New York. Additional authors for this research include Karla Kingsbury, Larry Amaya, Wioletta Kwolek, Mamta Shrestha and Di Coneybeare.

The publisher’s contact information for the The Journal of Emergency Medicine is: Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA.

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