SVU Member Survey: Summary of Calendar Year 2026 Proposed Medicare Payment Rules

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100% of survey complete.

Question Title

1. What’s top of mind for you about the CY2026 proposals?

Question Title

2. Your setting (select all that apply)

Hospital Outpatient Department – on-campus

Hospital Outpatient Department – off-campus (excepted/“grandfathered”)

Hospital Outpatient Department – off-campus (non-excepted)

Physician office

Independent Diagnostic Testing Facility (IDTF)

Other (free-text)

Question Title

3. Medicare share of your vascular ultrasound volume

<25%

25–49%

50–75%

>75%

Unsure

Question Title

4. Which services are a regular part of your Medicare work? (check all)

Carotid duplex (e.g., 93880/93882)

Transcranial Doppler (TCD) (e.g., 93886–93898)

Physiologic arterial testing (e.g., 93922-93924)

Dialysis access evaluation (e.g., 93990)

Venous duplex (e.g. 93970 bilateral/93971 unilateral/limited)

Complete bilateral physiologic studies, upper or lower extremity arteries, 3 or more levels: 93923 or lower extremity arteries at rest and following treadmill: 93924

Duplex scan of aorta, IVC, Iliacs, bypass grafts; complete study (93978)

Monitoring/ initial access mapping in ESRD patients: other codes such as 93985/6 may apply

Question Title

5. For any that selected above, estimate the number of Medicare exams/months?

0-10

11-25

26-50

51-100

>100

Question Title

6. Turning to APC’s: CMS assigns CPT codes for outpatient services to an Ambulatory Payment Classification (APC) group. APCs are hierarchical, with different levels reflecting varying resource intensity and cost.

APC 5522: Level 2 Imaging without Contrast. This is for less complex, lower-cost imaging services(93931, 93971, 93979, 93926,)

APC 5523: Level 3 Imaging without Contrast. This is for more complex, higher-cost imaging services.(Example: 93880, 93925, 93930, 93970, 93975, 93078, 93925, 93930)

Question Title

7. If you bill in HOPD, what is your current mix between APC 5522 vs 5523 for vascular ultrasound?

Mostly APC 5522 (>70%)

A mix (about 40–60% either way)

Mostly APC 5523 (>70%)

Not sure / N/A

Question Title

8. For non-facility sites (physician office/IDTF): are you seeing OPPS cap–limited payments on any vascular ultrasound codes?

Yes

Question Title

9. Comparator insight: carotid duplex vs echocardiography
Do you perform both exams in your organization?

Yes – carotid duplex and transthoracic echo (TTE)

Yes – carotid duplex and transesophageal echo (TEE)

Both TTE and TEE

No/Unsure

Question Title

10. If Yes to the above question: Based on typical cases, overall resource intensity (time, staff, equipment/room) is:

Similar for carotid duplex and echo

Echo is higher than carotid duplex ( Unsure: TEE usually higher- should we differentiate?)

Carotid duplex is higher than echo

Question Title

11. CMS has hinted at possible volume controls for Imaging Without Contrast APCs (5521–5524): if adopted in the future, The APC group would include a different level of imaging complexity, affecting reimbursement:

APC 5521: Level 1 Imaging without Contrast

APC 5522: Level 2 Imaging without Contrast

APC 5523: Level 3 Imaging without Contrast

APC 5524: Level 4 Imaging without Contrast

Question Title

12. What would the expected impact on your HOPD program be:

Significant Negative

Moderate Negative

Minimal/none

Unsure

N/A

SVU Member Survey: Summary of Calendar Year 2026 Proposed Medicare Payment Rules

Question Title

1. What’s top of mind for you about the CY2026 proposals?

Question Title

2. Your setting (select all that apply)

Question Title

3. Medicare share of your vascular ultrasound volume

Question Title

4. Which services are a regular part of your Medicare work? (check all)

Question Title

5. For any that selected above, estimate the number of Medicare exams/months?

Question Title

6. Turning to APC’s: CMS assigns CPT codes for outpatient services to an Ambulatory Payment Classification (APC) group. APCs are hierarchical, with different levels reflecting varying resource intensity and cost.

Question Title

7. If you bill in HOPD, what is your current mix between APC 5522 vs 5523 for vascular ultrasound?

Question Title

8. For non-facility sites (physician office/IDTF): are you seeing OPPS cap–limited payments on any vascular ultrasound codes?

Question Title

9. Comparator insight: carotid duplex vs echocardiography
Do you perform both exams in your organization?

Question Title

10. If Yes to the above question: Based on typical cases, overall resource intensity (time, staff, equipment/room) is:

Question Title

11. CMS has hinted at possible volume controls for Imaging Without Contrast APCs (5521–5524): if adopted in the future, The APC group would include a different level of imaging complexity, affecting reimbursement:

Question Title

12. What would the expected impact on your HOPD program be:

Question Title

13. Name (Optional)

Question Title

14. Organization (Optional)

Question Title

15. Email (optional)

SVU Member Survey: Summary of Calendar Year 2026 Proposed Medicare Payment Rules

Question Title

1. What’s top of mind for you about the CY2026 proposals?

Question Title

2. Your setting (select all that apply)

Question Title

3. Medicare share of your vascular ultrasound volume

Question Title

4. Which services are a regular part of your Medicare work? (check all)

Question Title

5. For any that selected above, estimate the number of Medicare exams/months?

Question Title

6. Turning to APC’s: CMS assigns CPT codes for outpatient services to an Ambulatory Payment Classification (APC) group. APCs are hierarchical, with different levels reflecting varying resource intensity and cost.

Question Title

7. If you bill in HOPD, what is your current mix between APC 5522 vs 5523 for vascular ultrasound?

Question Title

8. For non-facility sites (physician office/IDTF): are you seeing OPPS cap–limited payments on any vascular ultrasound codes?

Question Title

9. Comparator insight: carotid duplex vs echocardiography Do you perform both exams in your organization?

Question Title

10. If Yes to the above question: Based on typical cases, overall resource intensity (time, staff, equipment/room) is:

Question Title

11. CMS has hinted at possible volume controls for Imaging Without Contrast APCs (5521–5524): if adopted in the future, The APC group would include a different level of imaging complexity, affecting reimbursement:

Question Title

12. What would the expected impact on your HOPD program be:

Question Title

13. Name (Optional)

Question Title

14. Organization (Optional)

Question Title

15. Email (optional)

9. Comparator insight: carotid duplex vs echocardiography
Do you perform both exams in your organization?