Payments for Radionuclides The TC RVUs for nuclear medicine procedures (Procedure codes 78XXX for diagnostic nuclear medicine, and codes 79XXX for therapeutic nuclear medicine) do not include the radionuclide used in connection with the procedure. These...
Magnetic Resonance Angiography (MRA) Magnetic Resonance Angiography (MRA) Coverage Summary Section 1861(s)(2)(C) of the Social Security Act provides for coverage of diagnostic testing. Coverage of magnetic resonance angiography (MRA) of the head and neck,...
Computerized Axial Tomography (CT) Procedures A/B MACs (B) do not reduce or deny payment for medically necessary multiple CT scans of different areas of the body that are performed on the same day. The TC RVUs for CT procedures that specify “with contrast” include...
Medicare uses an outpatient prospective payment system (OPPS) to pay certain outpatient claims. With this method of reimbursement, the Medicare payment is not based on the amount the provider charges; therefore, the billed charges generally do not affect the current...
Medicare covers imaging services that are performed or supervised by a physician who is certified or eligible to be certified by the American Board of Radiology or for whom radiology services account for at least 50 percent of the total amount of charges made under...
Summary of Policies in the Calendar Year (CY) 2015 Medicare Physician Fee Schedule (MPFS) Sustainable Growth Rate (SGR) The Protecting Access to Medicare Act of 2014 provides for a zero percent update from the CY 2014 rates for services furnished between...
Specifically, the article summarizes the study’s objectives which were: 1) To determine the extent Medicare allowed claims for interpretation and reports of diagnostic radiology services focusing on Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and...
