The House of Delegates of the American Medical Association (AMA) has gone on record in support of paying adequately trained doctors for sonographic services, even if the exams are not provided by a radiologist.
"We felt it was necessary to approve this resolution because we found out that there are some insurance companies that aren't paying doctors for sonographic service, claiming that only radiologists are qualified to perform that function," said Dr. LaMar McGinnis, a general surgeon from Atlanta and an AMA delegate representing the Chicago-based American College of Surgeons.
The resolution, discussed at the AMA House of Delegates meeting in Chicago last month, affirmed that "ultrasound imaging is within the scope of practice of appropriately trained physicians, and that criteria for granting privileges for performing ultrasound procedures should be based on recommended training and education standards developed by each physician's respective specialty."
McGinnis said that when ultrasound technology first came on the scene a generation ago, radiologists were the primary operators. However, ultrasound is now an integral part of image-guided surgery.
"For a great many doctors, sonography has replaced the stethoscope for diagnosis in gynecology, gastroenterology, surgery, and many other fields," he said. The American College of Surgeons introduced the resolution because of reports from doctors that they were being turned down for reimbursement by insurers.
"Some of these doctors, who were denied reimbursement because they weren't radiologists, are experts in the use of sonography who travel around the world instructing other doctors in the proper use of the devices," McGinnis said.
The resolution noted that the payment exclusions "serve to limit patient access to state-of-the-art techniques used by physicians who are best-trained to treat the patient’s specific medical problems."
The resolution, which was unanimously approved by the House of Delegates, asks that the "AMA, in collaboration with other specialty societies, vigorously advocate with Medicare and other payors that all appropriately trained physicians -- regardless of specialty -- be reimbursed for performing diagnostic sonography, including sonographically directed biopsy, aspiration, etc., in situations with defined clinical indications."
By Edward SusmanAuntMinnie.com contributing writer
July 11, 2002
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Faster triage, more exams hailed as benefits of 24-hour ultrasound in ER, September 8, 2000
Copyright © 2002 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
