The Competition and Markets Authority  Didn't Just Cap Prescriptions — It Just Put a Spotlight on Your Ultrasound Fee

You've probably seen the headlines by now: "Pet prescriptions could be capped at £21." The Competitions and Markets Authority (CMA)'s final report on the vet sector landed in March, and the media ran straight for the number everyone could understand.

But the prescription cap isn't actually the part that should be keeping you up at night.

Buried a long way from the headlines, the CMA has said something that matters far more to anyone who scans: ultrasound now has to appear on your published price list, by name, with interpretation included.

That's not a threat. That's the best argument I've seen in years for taking your ultrasound reporting seriously, because it's finally something that shows the client the value of what you're delivering. 

What You'll Get in This Post

• What the CMA actually said about ultrasound (not just prescriptions)
• The "cross-subsidy" the CMA found — and why it's about to get harder to hide behind
• The real reason I think ultrasound gets undercharged (it's not the price list)
• Why a vague scan and a vague report are now a pricing liability, not just a clinical one
• What to actually do about it, this month

What the CMA Actually Said About Ultrasound

Everyone's talking about the £21 cap on written prescriptions. Fair enough — it's the easiest number to put in a headline. But three other decisions in the final report affect scanning far more directly than that cap ever will:

• A mandatory price list. Every first-opinion practice will have to publish a standard price for "Ultrasound (abdominal, single organ)" and "Ultrasound (echocardiogram)" — and the CMA has specified that this price must include interpretation. Not "scan only, report extra." One published number, and interpretation is inside it. 

• Itemised bills. Most practices already itemise a scan as its own line in my experience— however, it can get grouped in with a hospitalisation or workup charge rather than off the bill entirely. Either way, it's heading towards ultrasound being named and priced on its own, not buried in a bundle. ultrasound being a clearly named, standalone item, not part of a bundle.

• Written estimates for treatment pathways over £500. Where a scan is part of a bigger workup, owners need to see it coming, in writing, before the bill arrives.

None of this is new territory, exactly. It's a problem I think most of us in this field already recognise. What the CMA has done is put a spotlight on it.

The Cross-Subsidy You've Probably Never Called by That Name

The CMA looked hard at why professional fees — consultations, clinical time, diagnostics — have historically been priced so low compared to medicines. What they found is something most of us have felt for years: medicine mark-ups have long been used to prop up under-priced clinical skill. The CMA calls this a "cross-subsidy," and multiple large groups told the CMA outright that it's how their pricing structures have always worked.

The prescription fee cap and the wider scrutiny on medicine pricing chip away at that cushion. Which means the maths that's kept many practices comfortable — "the scan doesn't need to cover its own cost, the meds will sort it out" — can no longer be used as a crutch

If your ultrasound fee has ever felt like an afterthought next to the drugs on the bill, this is why. And it's also why now is the moment to change it.

The Real Reason I Think Ultrasound Gets Undercharged

The cross-subsidy explains the structure. But in my experience it's not the whole story.

I think a lot of ultrasound in first opinion practice is undercharged simply because the vet doing the scanning doesn't feel confident enough in their own skills to put a proper fee on it. The scan was useful. That's rarely the issue. What's actually going on is a nagging feeling of 'who am I to charge for this properly when I'm not a specialist.' That self-doubt shows up as a lower fee, a rushed write-up, or both. 

It's the same pattern I wrote about in what confident vets do differently — confidence, not competence, is usually what's holding the fee (and the report) back.

This is one of the things I've seen FOVU Report genuinely help with. Working through a consistent structure, every time, does two things at once: it makes the scan itself more thorough, and it gives you a finished, professional-looking report to hand over. That's the shift. Charging properly stops needing confidence, because the report already proves what you did. 

A Thin Report Used to Be Just a Clinical Problem. Now It's a Value Problem. 

The CMA's own definition of a healthy market spells this out plainly: pet owners have less expertise than their vets, can't independently weigh up the diagnostic and treatment options on the table, and can't judge the clinical quality of what they're actually getting — because, as the CMA puts it, that quality is "hard to measure and communicate to them." So owners lean on trust in their vet instead. That's always been true. But it used to just be an ethical and clinical issue.

Now there's a commercial edge to it too. Your ultrasound fee will sit on a published price list, next to every other practice's. The only thing that justifies that number to the owner in front of you is what you actually give them for it.

"We'll just have a quick look" was never great language for a scan. It's even worse when that "quick look" is a named, priced item on a public list. A structured report — what the pet came in for, what you found, what it means, what happens next — is the thing that makes the fee make sense. It's the difference between an owner who feels they got a proper answer and one who wonders what they actually paid for.

This is exactly why SPEEDS™ exists as a structure, a simple way to work through what you're seeing, organ by organ, so nothing gets missed and nothing gets left vague. And it's why  FOVU Report  exists as a way to produce that clarity quickly, every time, without staring at a blank page after every scan. Plus add link to 

Three Things I'd Do Before September

The CMA's remedies aren't live yet — most come into force through 2026 and into early 2027, with smaller practices given longer to comply. But this is happening. There's no advantage in waiting.  and there's no advantage in waiting.

1. Check what your price list actually says about ultrasound. If "ultrasound" doesn't appear as its own line, with interpretation stated as included, that's going to need fixing anyway — get ahead of it now rather than in a rush later.
2. Look at how you talk about the scan before you do it. "To rule out urgent problems and guide the next steps" does more work than "a quick look" — for the owner's understanding and for your own confidence in the fee.
3. Make the report the visible product of the scan, not an afterthought. A structured summary — purpose, findings, meaning, plan — is what turns "I had an ultrasound" into "the vet found X and that's why we're doing Y." That's what an itemised bill needs to hold up.

FAQ

Does this mean I need to raise my ultrasound prices? Not necessarily. It means your existing price needs to be visibly justified — through clear communication and a proper report — because owners will be able to compare that price across practices more easily than before.

Is the prescription fee cap the bigger issue for my ultrasound work? Only indirectly. It matters because it narrows how much medicine revenue can quietly subsidise everything else. The price list and itemised billing remedies are the ones that touch ultrasound directly.

When do I actually need to comply? The CMA expects its Order to be in force by September 2026, with businesses then given a further period to comply — generally longer for smaller practices. There's no need to panic, but there's also no reason to leave it until the deadline.

Takeaway

The prescription cap will grab the headlines. The price list and itemised billing remedies are the ones that will actually change how your ultrasound fee gets seen — by owners, and by you. A scan that's backed by a clear, structured report has never needed defending. Under these reforms, that's about to matter more than ever.

Next Step

See how FOVU Report helps you write clear, structured ultrasound reports in minutes — so every scan on your price list is backed by something worth the fee.

Author bio: Dr. Camilla Edwards (DVM, CertAVP, MRCVS) is a peripatetic veterinary ultrasonographer and founder of FOVU. She helps first-opinion vets build confidence in scanning and reporting so they can deliver better care with less stress.

Source: CMA, Veterinary services for household pets: Final decision report, 24 March 2026