Payments for overseas contractors who read radiology films
Compliance Monitor, June 8, 2007
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Q: Our hospital contracts with a radiology group that provides credentialed physicians from overseas to read radiology films in the middle of the night. I have heard that there is a new Medicare transmittal that states the reading and the film are not covered when the reading takes place outside the United States. Is this true?
A: Yes, this is true. CMS released Transmittal 66, Change Request 5427, ("Services Not Provided Within United States") on February 23, 2007. Transmittal 66 has an effective date of November 13, 2006, and an implementation date of April 2, 2007.
You can find Transmittal 66 at the CMS Web site: www.cms.hhs.gov/Transmittals/Downloads/R66BP.pdf. It states the following:
Payment may not be made for a medical service (or a portion of it) that was subcontracted to another provider or supplier located outside the United States. For example, if a radiologist who practices in India analyzes imaging tests that were performed on a beneficiary in the United States, Medicare would not pay the radiologist or the U.S. facility that performed the imaging test for any of the services that were performed by the radiologist in India.
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- HIPAA Q&A: Level of encryption needed for email
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- CMS has reformulated payments for some bilateral procedures
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- ED-to-inpatient transfers are flawed with safety gaps
- Searched