Reimbursement

A FibroScan® based risk stratification strategy can reduce Liver Disease diagnosis and management costs, resulting in a better allocation of resources.

FibroScan® is reimbursed under CPT code 91200

FibroScan examinations, as part of an overall care management plan, can lead to reduced costs, improved outcomes, and improved patient satisfaction. Care delivery models featuring FibroScan are currently in practice or in development. NASHNet hospital systems have already started to generate real world evidence to support FibroScan based platforms to more efficiently and effectively identify and manage patients with fibrotic-NASH in the hospital setting.

FibroScan can also enhance population health management by improving diagnosis accuracy at the point of care to allow for better accounting for health risks among the populations served. 

Provider & Health Plan Benefits

  • Improves access to care
  • Provides testing at the point of care to reduce unnecessary specialist referrals and allow for earlier, targeted interventions
  • Optimizes the healthcare provider role in medical home
  • Painless and takes less than 10 minutes, with minimal patient preparation and limited disruption in patient workflow
  • Noninvasive technology allows physicians to easily estimate liver stiffness and fat content
  • Quantitative measure that allows consistent tracking of liver health over time
  • Aid to rule out those who don’t need more testing so resources can be focused on patients who do.
  • Establishes liver health in the chronic care management of patients with metabolic syndrome

Hospital Coding Guide

FibroScan devices are FDA cleared as an aid to diagnosis and monitoring of adult patients with liver disease, as part of an overall assessment of the liver. FibroScan devices utilize proprietary VCTE™, which applies a mechanically induced shear wave and does not utilize diagnostic imaging.

Testing is Covered Under
Category I CPT Code 91200

Liver elastography, mechanically induced shear wave (e.g. vibration), without imaging, with interpretation and report: CPT Code 91200 for 2019.

Hospital Outpatient Medicare Payment $135.95 (APC 5721)
*CMS Hospital Outpatient Prospective Payment System 2019 Final Rule – CMS 1695-FC

Frequently Asked Questions

Is there a CPT code for the FibroScan examination?

Yes, testing billed under the new CPT category I code 91200 is specific to the FibroScan examination.

How do hospital or outpatient facilities bill for a FibroScan examination?

Hospital outpatient clinics performing the FibroScan examination should bill 91200. Coverage and payment of FibroScan examination may vary by commercial payers.

How do hospital physicians bill for reviewing and reporting the FibroScan examination?

The physician charging for test interpretation and reporting will bill 91200-26 which is 0.40 RVU. Coverage and payment for FibroScan examination may vary by commercial payers.

Who may I contact with my questions about FibroScan examination reimbursement?

Echosens™ maintains a Reimbursement Hotline at (866) 905-4837, option number 4.

Physician Office Coding Guide

Frequently Asked Questions

Is there a CPT code for the FibroScan examination?

Yes, category 1 CPT code 91200 is specific to the FibroScan examination.

How do physician offices bill for a FibroScan examination?

Physician offices performing the FibroScan examination should bill 91200. Coverage and payment of a FibroScan examination may vary by commercial payers.

Who may I contact with my questions about FibroScan examination reimbursement?

Echosens™ maintains a Reimbursement Hotline at 866-905-4837, option number 4.

FibroScan Testing is Covered Under Category I CPT Code 91200
Liver elastography, mechanically induced shear wave (e.g. vibration), without imaging, with interpretation and report: CPT Code 91200 for 2019.

Physician Office Medicare Payment $39.65 (1.14 RVU)
*CMS Physician Fee Schedule CY2019 Final Rule 1693-F. Conversion Factor 36. 0391

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In North America there are over 1200+ FibroScan systems in operation & we’re growing!

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