tci Medicare Compliance & Reimbursement - 2004 Issue 28

PHYSICIANS: Group Practices Performing Diagnostic Tests, Beware

Tests won't be incident-to any longer, CMSofficials say. For decades, physician practices have been billing diagnostic tests on an "incident-to" basis if the physician supervised them. Now the Centers for Medicare & Medicaid Services is saying that's incorrect. Despite numerous official issuances and statements to the contrary, a group of CMS officials have decided that diagnostic tests can never be billed incident to a physician's services. While this doesn't affect the reimbursement levels for the tests, it does prevent an individual physician from receiving compensation for the tests within a group practice. "Diagnostic tests do have a benefit category...

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