Objectives: The aim of this study was to determine the fiscal impact of implementation of a novel emergency
department (ED) point-of-care (POC) ultrasound billing and reimbursement program.
Methods: This was a single-center retrospective study at an academic medical center. A novel POC ultrasound
billing protocol was implemented using the Q-path Web-based image archival system. Patient care
ultrasound examination reports were completed and signed electronically online by faculty using Q-path. A
notification was automatically sent to ED coders from Q-path to bill the scans. ED coders billed the
professional fees for scans on a daily basis and also notified hospital coders to bill for facility fees. A fiscal
analysis was performed at the end of the year after implementing the new billing protocol, and a before-and after comparison was conducted.
Results: After implementation of the new billing program, there was a 45% increase in the ED faculty
participation in billing for patient care examinations (30%-75%). The number of ultrasound examinations
billed increased 5.1-fold (4449 vs 857) during the post implementation period. The total units billed
increased from previous year for professional services to 4157 from 649 and facility services to 3266
from 516. During the post implementation period, the facility fees revenue increased 7-fold and
professional fees revenue increased 6.34-fold. After deducting the capital costs and ongoing operational
costs from approximate collections, the net profits gained by our ED ultrasound program was
approximately $350 000.
Conclusions: Within 1 year of inception, our novel POC ultrasound billing and reimbursement program
generated significant revenue through ultrasound billing.