GAO Issues Report that Supports Credentialing and/or Accreditation for Medicare Ultrasound Procedures

On Thursday, June 28, the U.S. Government Accountability Office (GAO) issued a detailed report on “Medicare Ultrasound Procedures: Consideration of Payment Reforms and Technician Qualifications/ Requirements” that recommends that “CMS should require sonographers providing Medicare-covered ultrasound exams to either be credentialed or work in an accredited facility.”

The GAO Report states:

“The skill of the sonographer conducting an ultrasound is critical for its use to support a physician’s correct diagnosis; poorly captured images can lead to misdiagnoses or unnecessarily repeated exams. Findings from several peer-reviewed studies, the Medicare Payment Advisory Commission, and ultrasound-related professional organizations support requiring that sonographers either have credentials or operate in facilities that are accredited, where specific quality standards apply.

“In some localities and practice settings, CMS or its contractors have required that sonographers either be credentialed or work in an accredited facility. Medicare’s inconsistent requirements undermine assurance that beneficiaries are receiving high-quality services across the country.”

CMS responded to GAO by stating that it would consider the GAO recommendations but would prefer that states engage their own licensing bodies in implementing sonographer licensure programs. CMS stated that a national policy would not take into account regional variation in factors such as access to care and state licensing requirements.