On July 1, 2010 Medicare started paying less for certain imaging procedures when performed in the same imaging session due to a provision in the new health care act.

The TC portion of the claim is affected, not the professional component, and only when Medicare considers the scans to be in a contiguous imaging family and they are performed together.

Example:

If you perform an MRI of the cervical, thoracic and lumbar spinal regions in the same session, Medicare will now reduce the 2nd and 3rd procedure by 50%.

Also, if you own your own MRI or CT or Ultrasound equipment, you are now required to inform your Medicare patients about competing imaging options when you prescribe those services.

Section 6603 of the Patient Protection and Affordable Care Act (PPACA) requires a referring physician to inform the patient in writing that the individual may obtain the service from a person other than the referring physician.

The new rules don’t provide details concerning exactly what must be included on the form other than a requirement for providing referral information that is convenient to the patient.\

Call PMA today at 1-800-322-4606.