UK Reimbursement for AI Echocardiography

Adult echocardiography in NHS England groups to the diagnostic-imaging RD subchapter: RD50Z (Simple Echocardiogram) for routine TTE, and the RD51A / RD51B / RD51C complexity-split for complex adult and paediatric studies. The HRG is derived from the OPCS-4 procedure code recorded on the episode and the patient's clinical complexity. (Source: NHS England HRG4+ 2022/23 grouper.)

NHS England's National Cost Collection 2022/23 reports a national mean unit cost of £114 for RD50Z (Simple Echocardiogram) and £121 for RD51A (Complex Adult Echo, low-CC) in the outpatient imaging setting. A consultant-led cardiology follow-up attendance (WF01A, TFC 320) is £173 and a first attendance (WF01B) is £205, so a typical echo plus consultant review sits in the £290–£325 range. Departmental "marginal-cost" allocations (often £80–£95 per scan, excluding consultant time and overhead) sit below this and are not directly comparable to the NCC unit cost. (Source: NHS National Cost Collection 2022/23.)

Under the NHS Payment Scheme, most acute services including diagnostic echo are paid through Aligned Payment & Incentive (API) block contracts based on prior-year activity, not per-case. National Tariff "unit prices" published in the annual tariff workbook are planning prices, not per-scan payments. The NCC unit cost is therefore the most useful public anchor for the full economic cost of an echo episode, while departmental budgets are typically set against the prior-year activity baseline.

OPCS-4 is the NHS classification used to record what procedure was performed (e.g., U20.1 for diagnostic TTE). HRG is the payment grouping derived from OPCS-4 plus diagnostic and demographic data. OPCS-4 itself carries no tariff; payment flows through the associated HRG under the NHS Payment Scheme.

As of the current NHS Payment Scheme, there is no UK equivalent of the US Category III CPT code for AI-assisted heart failure detection. AI-assisted reporting today sits within the existing RD50Z / RD51A HRGs, with the value case typically built around throughput, reporting-turnaround, and clinical quality rather than additional payment.

The Clinical Coding & Schedule Development (CCSD) Group maintains the de-facto coding standard for UK private medical billing, used by BUPA, AXA Health, Vitality, WPA, Aviva and others. Echocardiography sits under CCSD 8200 for transthoracic echo. The CCSD schedule itself is the authoritative reference for the codes; individual insurer fee levels are commercially confidential and vary by consultant grade and hospital network. Directional market rates are typically around £150 (insurer) and £250 (self-pay) per TTE. Private volume is a small minority of total UK echo activity, so this is not the primary commercial lever for most NHS-facing services.

Yes. Us2.ai is registered with the MHRA for use in Great Britain as a Class IIb medical device. CE marking under EU MDR also applies in Northern Ireland under the Windsor Framework. See the Regulatory Status page for the full clearance and registration list.

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CDCs are funded through the same HRG-based mechanism as hospital outpatient diagnostics, with commissioning aligned to elective recovery and Long Term Plan throughput targets. AI-assisted reporting supports CDC throughput by reducing per-study analysis and measurement time without changing the HRG that the episode groups to.

Our team can provide detail tailored to your trust or private group, including DSPT/DTAC documentation, current MHRA registration, and supporting evidence for business cases. Contact us for UK-specific guidance.