decisionhealth Newsletters, Part B News - 2005 Issue 4 (April)
Locality rate pay plan for purchased tests delayed by CMS
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Article Overview
This piece covers a CMS delay in implementing a locality-based payment approach for purchased diagnostic tests and describes how the change affects physician practices and independent diagnostic testing facilities. It is relevant to Medicare billing staff, physician offices, diagnostic testing facilities, and revenue cycle professionals tracking claims processing updates, enrollment implications, and service-location reporting requirements.
Why This Topic Matters
The article helps readers understand a Medicare payment and claims-processing change that can affect where diagnostic services are reported and how they are reimbursed. It is important for organizations that bill purchased tests and need to monitor CMS operational guidance, locality payment handling, and filing requirements.
What You Will Learn
- How CMS is handling locality-based payment for purchased diagnostic tests
- How the policy differs for physician billing versus independent diagnostic testing facilities
- Why service-location reporting on Medicare claim forms matters for payment processing
- Which types of Medicare billing entities are affected by the update
Who Should Read This
- Physician office billing staff
- Medicare claims processors
- Revenue cycle managers
- Independent diagnostic testing facilities
- Compliance and reimbursement professionals
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