ACloserLook Reimbursement Issues in Diagnostic Imaging

Anti-Markup Provisions Delayed

On January 3, 2008, the Centers for Medicare & Medicaid Services (CMS) issued a final rule delaying until January 1, 2009 the applicability of certain anti markup provisions. The exceptions are those relative to the technical component of a purchased diagnostic test and any anatomic pathology diagnostic testing services furnished in certain spaces that are utilized by a physician group practice. Medicare rules currently prohibit profiting from, or marking up, the technical
component (TC) of certain diagnostic tests that outside suppliers perform but which a different individual or entity bills to Medicare. The proposed provisions would have prevented billing physicians from marking up either the technical or professional component of diagnostic radiology services.

The final rule can be found in the Federal Register at: http://www.access.gpo.gov/su_docs/fedreg/a080103c.html.

Winter 2008 Newsletter


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