Medicare_Carriers_Manual / 3060 / 3060._REASSIGNMENT

Why This Topic Matters

Reassignment rules affect who may receive Medicare payment and when payment arrangements are permitted. Understanding the scope of these rules helps organizations evaluate billing workflows, contractual structures, and compliance risk.

Article Sections

1. Ed. Note

   References to related manual chapters for hospital-based pathology and radiology services.

2. 3060. Reassignment

   Overview of Medicare reassignment policy, including the general rule, exceptions, and related payment concepts.

3. A. Basic Prohibition

   General prohibition on payment to parties other than the furnishing physician or supplier, including discussion of direct payment concepts.

4. B. Exceptions

   List of circumstances in which payment may be made to other parties under specific reassignment arrangements.

5. C. Background and Purpose

   Policy background explaining the rationale for reassignment limitations and related payment restrictions.

6. D. Who Is Supplier of Services

   Discussion of who is treated as the supplier for reassignment purposes and how purchased services or items are viewed.

7. E. Effect of Payment to Ineligible Recipient

   Administrative effect of payment made to an ineligible recipient and related enforcement considerations.

8. F. Reassignments by Nonphysician Suppliers

   Application of reassignment concepts to nonphysician suppliers and arrangements involving participating providers.

9. G. Effect of Reassignment on Assignment Agreement

   How reassignment interacts with assignment agreements, contractual billing authority, and opt-out status.