CMS proposes to add new services to Stark II, Phase II self-referral list

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article summarizes CMS’s proposed changes to the Stark II, Phase II designated health services list in connection with the 2005 physician fee schedule. It is relevant for healthcare compliance, physician billing, radiology, therapy, and laboratory stakeholders who need to understand how the proposed additions, deletions, and screening-related exceptions are organized and discussed at a high level.

Why This Topic Matters

The piece helps readers track changes to federal self-referral policy that can affect service reporting, referral relationships, and compliance review. It is especially useful for organizations monitoring which service categories were newly added, which were removed, and which screening-related items were addressed in the rulemaking context.

Article Sections

  1. Overview of proposed Stark II Phase II changes

    Introduces the CMS proposal and the context of the 2005 physician fee schedule update. Summarizes that the article focuses on additions, deletions, and related self-referral list changes.

  2. Clinical lab services

    Lists newly referenced laboratory-related services discussed in the proposal. The section places them within the broader Stark II designated health services framework.

  3. Radiation therapy services/supplies

    Covers the radiation therapy-related services and supplies identified in the update. The section reflects how the article groups these services for comment and review.

  4. PT, OT, speech language pathology services

    Addresses therapy-related services included in the proposed list changes. The section presents them as part of the overall self-referral discussion.

  5. List of new preventive screening, immunization and vaccine codes NOT subject to the Stark II/Phase II prohibition under limited circumstances

    Describes a separate group of preventive, screening, immunization, and vaccine-related items discussed in the article. The section also notes the limited-circumstance framework referenced by the source.

  6. Radiology and certain other diagnostic services

    Covers diagnostic and imaging-related services identified in the proposal. The section includes the article’s discussion of this category and related screening references.

What You Will Learn

  • How CMS organized proposed changes to the Stark II, Phase II designated health services list
  • Which broad service categories were included in the update
  • How the article frames screening-related exceptions and limited-circumstance references
  • Which services were noted as removed from the existing list
  • How the proposal relates to the 2005 physician fee schedule and federal rulemaking

Who Should Read This

  • Physician practices
  • Hospital compliance teams
  • Medical coders
  • Billing staff
  • Healthcare attorneys
  • Radiology departments
  • Laboratory managers
  • Therapy providers

Codes Discussed


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