In Florida, any diagnostic ultrasound falls under the State’s definition of a “diagnostic‑imaging service,” and by law may only be performed on the basis of a valid order or referral from a licensed provider. Specifically:

Definition of diagnostic imaging: Florida Statutes § 456.053(3)(d) expressly includes “ultrasound” in its list of “diagnostic‑imaging services” Findlaw.

Requirement for referral/order: Under § 456.053(4)(a), a group practice or sole provider may not perform—or accept outside referrals for—any diagnostic‑imaging service unless it is provided pursuant to a referral (i.e., an order) from a physician or other licensed health care provider. No exam may be billed or performed without that referral Findlaw.

This statute, often called Florida’s Patient Self‑Referral Act, was enacted to ensure that imaging studies are appropriately prescribed, to prevent unnecessary testing, and to avoid conflicts of interest.

No matter if you are using a self-paid option, without insurance.

In Florida “ultrasound” is statutorily a “diagnostic‑imaging service,” and state law says it may only be performed on the basis of a referral (i.e. an order) from a licensed health‑care provider—no matter who’s paying. There is no carve‑out for cash/self‑pay patients.

“Diagnostic imaging services” include ultrasound. Florida Statutes § 456.053(3)(d) defines diagnostic‑imaging services to include ultrasound Findlaw.

Referral required for any diagnostic imaging. Under § 456.053(4)(a), a group practice or sole provider may not perform—or accept referrals for—diagnostic imaging unless there is a valid referral/order from a physician or other authorized provider. There is no exception for self‑pay exams Findlaw.

So even if you intend to pay out‑of‑pocket, the facility must have a proper order from an appropriate licensed provider before doing the scan.

Florida Law Overrides the "Screening Exemption" Common in Other States

In many states, screening ultrasounds may be offered without a referral, especially when marketed as direct-to-consumer services. However, Florida does not allow this.

Under Florida Statute § 456.053, any ultrasound, regardless of purpose (screening or diagnostic), is legally defined as a “diagnostic imaging service”, and must be ordered by a licensed healthcare provider—even if:

1-The patient is asymptomatic
2-The exam is advertised as a “screening”
3-The patient is paying cash
4-The ultrasound is not intended for diagnosis but for “peace of mind” or prevention

In Florida, 3D/4D pregnancy ultrasounds offered without a referral must be strictly non-diagnostic and clearly labeled as entertainment to avoid violating diagnostic imaging laws.

If there’s any diagnostic element, an order is legally required. 

Non-Diagnostic 3D/4D Ultrasound (Keepsake / Entertainment Purpose):

No medical information provided or documented
No interpretation or radiology report issued
Used solely for bonding or photos/videos of the baby