TC and PC markup restrictions affect urologists

Why This Topic Matters

Changes to anti-markup rules can alter how diagnostic testing services are billed and reimbursed, especially for practices that use leased, off-site, or contracted pathology resources. Understanding the policy context helps groups assess compliance and revenue impact.

Article Sections

1. Anti-markup restriction under the Medicare physician fee schedule

   Overview of the policy framework for diagnostic test components and the circumstances discussed in the final rule.

2. Impact on urology pathology arrangements

   Discussion of how the policy affects urology groups that use off-site laboratories, leased personnel, or contracted pathology services.

3. CMS examples involving prostate biopsies

   Summary of the illustrative scenarios used by CMS to show the policy in practice for urology-related testing arrangements.

4. Commentary on multiple-core prostate biopsies

   Review of stakeholder comments addressing biopsy volume, practice patterns, and concerns about incentives and patient care.