Q: Can I claim for ultrasound guided procedures or not?
A: Ultrasound guidance can no longer be claimed for vascular access, however it is still claimable for a number of other ultrasound guided procedures.
Scope: All ICU procedures where real time ultrasound guidance may be used
Details:
In the past, item 55054 was widely claimed for real-time ultrasound guidance with many procedures.
Over time, ultrasound guidance has become recognised as standard of care for vascular access and anaesthetic interventions, meaning it is considered part of the procedure rather than a separate billable service.
Banned combinations:
Cannot be claimed with any anaesthesia item. IN.0.14
Cannot be co-claimed with arterial lines, central lines, VV or VA ECMO cannulation, or microaxial blood pump (Impella) insertion.
Permitted combinations:
Ultrasound guidance can still be co-claimed with some ICU procedures such as chest drains, pericardiocentesis, and paracentesis, amongst others.
⚠️ Important: Services Australia’s validation rules may block even unrelated diagnostic imaging items, so careful attention is required.
👉 For a deeper dive, read our article in the Navigating the Maze series and watch out for an upcoming full instalment devoted to ultrasound use in Intensive Care. You can also watch the full Q&A video here:
Disclaimer
This blog is provided for educational and general informational purposes only and does not constitute legal, medical, or financial advice. While every effort has been made to ensure accuracy, billing requirements under the Medicare Benefits Schedule (MBS) are complex and subject to change. Clinicians should always consult the official MBS, relevant hospital policies, or seek independent professional advice before making billing decisions. While we use reasonable effort to ensure that our overview articles are accurate, current and complete, we do not represent, warrant, or guarantee (to the maximum extent permitted by law) their accuracy, currency, or completeness or imply that they are applicable to your individual situation. ClaimLogic accepts no liability arising from for actions taken based on the content of this article.
Máté Rudas
Dr Rudas is the Director and Founder of ClaimLogic.
He is Senior Staff Specialist at Royal Prince Alfred Hospital in Sydney. His clinical interests include critical care ultrasound, advanced haemodynamic monitoring and mechanical cardiorespiratory support. He is a member of the CICM Ultrasound Special Interest Group, an examiner for the ASUM DDU (Crit Care) and works as part of the NSW ECMO Retrieval Service.
Other interests include medical billing, clinical informatics and health facility design. Roles include Clinical IT lead at NBH and ICU clinical co-lead for the RPA ICU redevelopment project.
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