Good Morning,
We are a free standing facility that bills out with a office POS globally to Medicare, looking at the reimbursement we are receiving they are using the OPPS Cap Facility Reimbursement. If we are not an outpatient hospital shouldn't they pay the global reimbursement?
Per Medicare "Amounts for which providers [performing the service in a facility setting] would be reimbursed when the Outpatient Prospective Payment System (OPPS) Cap on the Technical Component (TC) of Imaging Procedures applies. (Check the "Imaging Cap Indicator" below) Place of service codes which identify a facility setting: 21, 22, 23, 24, 26, 31, 34, 41, 42, 51, 52, 53, 56, 61".
We do not bill out with these POS so the CAP shouldn't apply correct?
Any clarification or insight would be appreciated, thank you.
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Diane Ramirez
Business Office Manager
Radiology and Imaging of South Texas LLP
Corpus Christi TX
361-853-4503
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