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Why This Topic Matters

Diagnostic test billing can change depending on who performs the service, who interprets it, and whether anti-markup rules apply. Understanding the Medicare Part B rules discussed here can help practices evaluate compliance and payment exposure for contracted diagnostic services.

Article Sections

1. Provider question on ultrasound billing arrangements

   The article opens with a practice scenario involving on-site diagnostic ultrasound studies and outsourced interpretation. It frames the billing and payment issue being addressed under Medicare Part B.

2. Response on Part B payment for diagnostic test components

   This section summarizes the general Medicare policy for payment of technical and professional components when another physician or supplier performs part of the service. It also introduces the anti-markup payment limitation and related enrollment and contractual considerations.

3. Internet resource and submission information

   The closing section points readers to a CMS manual resource and provides contact information for submitting future questions. It also includes standard publication notes about the source of the answers.