Two tests check whether Medicare’s anti-markup rules apply to your dx tests

Article Overview

This article covers Medicare anti-markup policy for diagnostic testing and explains the two CMS tests used to determine whether those rules apply when professional or technical components are purchased. It is aimed at billing, compliance, and coding professionals who need a high-level understanding of the policy framework and the general factors CMS considers. The discussion is useful for readers tracking Medicare physician fee schedule guidance and related diagnostic service arrangements.