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Watch out for new anti-markup rules

Ambulatory Surgery Reimbursement Update, November 20, 2007

CMS released its 2008 Medicare Physician Fee Schedule (MPFS), which included new anti-markup rules for technical and professional components of diagnostic tests on November 1, according to the CMS Web site.

CMS states in the final rule that "We are imposing an anti-markup provision on TCs [technical components] of diagnostic tests that are ordered by the billing physician or other supplier (or ordered by a party related by common ownership or control to such billing supplier), if the TC is outright purchased or if the TC is performed at a site other than the office of the billing physician or other supplier."

For the purpose of the anti-markup rule, "office of the billing physician or other supplier" means "space where the physician or other supplier regularly furnishes patient care," according to the rule.

To view the 2008 MPFS rule, click here.

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