Set-Up Component (HCPCS Code Q0092)

A/B MACs (B) must pay a set-up component for each radiologic procedure (other than retakes of the same procedure) during both single patient and multiple patient trips under Level II HCPCS code Q0092. A/B MACs (B) do not make the set-up payment for EKG services furnished by the portable x-ray supplier.

90.5 – Transportation of Equipment Billed by a SNF to a MAC

(Rev. 3230, Issued: 04-03-15, Effective: 06-15-15, Implementation: 06-15-15)

When a SNF bills for portable x-ray equipment transported to a site by van or other vehicle, the SNF should bill for the transportation costs using one of the following HCPCS codes along with the appropriate revenue code:

Code                                                 Description

R0070            Transportation of Portable x-ray Equipment and Personnel to Home or Nursing Home, Per Trip to Facility or Location,  One Patient Seen.

R0075          Transportation of Portable x-ray Equipment and Personnel to Home or Nursing Home, Per Trip to Facility or Location, More than One Patient Seen, Per Patient.

These HCPCS codes are subject to the fee schedule.

Effective April 1, 2006, SNFs are required to report the appropriate modifiers to identify the number of patients served when billing for R0075. See section 90.3, of this chapter for the list of modifiers used to identify on the claim the number of patients served.

MACs shall ensure that payment for R0075 is consistent with the definition of the modifiers.

NOTE: When a SNF resident receives a portable x-ray service during the course of a Medicare-covered stay in the SNF, only the service’s professional component (representing the physician’s interpretation of the test results) is a separately billable physician service under Part B (see §20.1 of this chapter and §20.1.1 of Chapter 6). By contrast, the technical component representing the procedure itself, including any associated transportation and setup costs, would be subject to consolidated billing (the SNF “bundling” requirement for services furnished to the SNF’s Part A residents), and must be included on the SNF’s Part A bill for the resident’s covered stay (Bill Type 21x) rather than being billed separately under Part B