The Centers for Medicare and Medicaid Services (CMS) accepted the application for a HIFU C-code which went into effect on July 1st, 2017.
The HCPCS code C9747, under the ambulatory payment classification (APC) 5376, is specific to the ablation of prostate tissue using transrectally delivered high intensity focused ultrasound (HIFU), and includes image guidance. It will be applicable to procedures performed using Sonablate®, including but not limited to primary whole gland ablation, sub-total ablation, and salvage ablation. This C-code is applicable to procedures performed in hospitals and ASC facilities under the Medicare Hospital Outpatient Prospective Payment System (OPPS) and may also be applied to claims from other providers in the future.
Please contact a HIFU physician in your area to learn more about reimbursement.