Cap on the TC Component

Effective for dates of service on or after January 1, 2007, the Deficit Reduction Act (DRA) of 2005 limits the TC payment for most imaging procedures paid under the Medicare Physician Fee Schedule to the amount paid under the Outpatient Prospective Payment System (OPPS). The provision applies to TC-only services and the TC of global services. The PC is paid in full for all procedures.

For imaging services subject to both the multiple imaging reduction policy and the outpatient hospital cap, CMS is applying:

* First, the multiple imaging adjustment.
* Second, the outpatient cap.