As a condition of fee schedule payment, services are required to contribute directly to the diagnosis or treatment of an individual beneficiary.5 When Medicare Administrative Contractors (MAC) receive a single claim for interpretation and report, “they must...
CMS’s guidance on payment for interpretation of diagnostic tests furnished to emergency room patients offers inconsistent direction regarding whether interpretations are payable only if they were performed while patients were in the emergency room. According to CMS...
BACKGROUND The Social Security Act and Centers for Medicare & Medicaid Services (CMS) regulations govern Medicare payments for all radiology services and require that services be medically necessary, have documentation to support the claims, and be ordered by...
