Physician Notes: Purchasing Tests Outside Your Carrier's Region Won't Be A Problem Soon

Why This Topic Matters

The article summarizes policy and systems changes that affect how Medicare claims are accepted, priced, and screened across carrier jurisdictions. It also highlights the operational impact on providers and carriers as they adapt to CMS instructions and related database updates.

Article Sections

1. Purchased diagnostic tests and carrier jurisdiction

   Discusses CMS billing updates affecting purchased diagnostic tests or interpretations and the move toward a national abstract file for local processing.

2. Physician drug pricing and carrier system implementation

   Summarizes CMS guidance on physician drug pricing methodology and the related carrier system format changes needed to process updated payment data.

3. Other CMS transmittals and Medicare spending commentary

   Covers additional CMS instructions involving drug pricing databases, duplicate-claim edits, and a brief discussion of Medicare physician spending trends.