Imaging Centers Billing for Out of State Interpretations Can Expect Claim Denials

By Adrienne Dresevic, Esq. and Carey F. Kalmowitz, Esq.

April 2010–Effective March 15, 2010, pursuant to CMS’ update to the Medicare Claims Processing Manual addressing “Payment to Physician or Other Supplier for Diagnostic Tests Subject to the Anti-Markup Payment Limitation,” among other actions, CMS has effectively eliminated an IDTF’s or radiology group’s ability to bill its local carrier (MAC) for interpretations performed by out of state physicians (the CMS Change Request).

Healthcare Marketing—Navigating the Regulatory Landscape

By Adrienne Dresevic, Esq. and Carey F. Kalmowitz, Esq.

January 2010 — Marketing is an integral component of any business enterprise’s efforts to maintain and expand its economic base. At the beginning of this New Year, many imaging providers likely will strategize about their 2010 marketing programs as they contemplate the prospects of declining reimbursement and heightened regulatory scrutiny.