tci Part B Insider - 2004 Issue 23

FRAUD & ABUSE - Separate Tests Vs. Incident-To: A Stark Difference

Individual physicians could lose out under new CMS interpretation At first glance, the new policy that the Centers for Medicare & Medicaid Services sneaked under the radar regarding "incident-to" diagnostic tests may appear to be a minor issue. After all, Medicare reimburses the same amount for tests whether they're billed incident-to or under the provider number of the person who performed them. And physicians can still bill globally for both technical and professional components, even if they can't bill incident-to for tests, CMS officials told attorney Alice Gosfield with Gosfield & Associates in Philadelphia, PA. In fact, with no...

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