Purchased tests to be billed locally, but paid based on where test was done beginning in April

Why This Topic Matters

Locality-based payment can change reimbursement for purchased diagnostic tests and affect how claims must be submitted and processed. Understanding the update helps practices avoid unprocessable claims and align billing with carrier expectations.

Article Sections

1. Payment locality update for purchased diagnostic tests

   Summarizes the CMS change affecting how purchased diagnostic tests are paid beginning with April 2005 dates of service. It also notes that the agency will provide and update a list of eligible services.

2. Claim handling when services occur in different locations

   Describes the general billing scenario where different components of a diagnostic service are performed in separate places. It explains the claim-processing context and the importance of reporting components in a way carriers can process.