Payment to Non-Indian Health Service Physicians by Indian Health Service (IHS) Providers for Teleradiology Interpretations (Rev. 1643, 03-09-09)

by  Jared Staheli
June 25th, 2015

The IHS providers may choose to purchase or otherwise contract for teleradiology interpretation from non-IHS practitioners. Two options are available for payment for these services.

(1) Contractual Reassignment – Under this provision, non-IHS physicians can reassign their benefits to the IHS hospital where the technical component is performed. Non-IHS practitioners providing these services shall enroll with the designated A/B MAC contractor for IHS and complete a Form CMS-855-R form for each IHS hospital performing the test. Because of IHS status, state licensure and location of the physicians is not an issue and the designated A/B MAC contractor shall make payment based on the Medicare locality in which services are rendered in accordance with current jurisdictional pricing guidelines (see §80.2, paragraph 6 of this Chapter).

Purchased Test – The purchased test method is available for all purchased diagnostic tests including radiology, and the requirements are found in Chapter 1. Payment for teleradiology interpretations under the purchased test option does not require non-IHS physicians’ enrollment with the designated A/B MAC contractor for IHS. All general jurisdictional and pricing rules apply for payment for these services.

References:

Payment to Non-Indian Health Service Physicians by Indian Health Service (IHS) Providers for Teleradiology Interpretations (Rev. 1643, 03-09-09). (2015, June 25). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/payment-to-non-indian-health-service-physicians-by-indian-health-service-ihs-providers-for-teleradiology-interpretations-rev-1643-03-09-09-26886.html

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