Practice Management

Hello All:

​It's been a while since I've reviewed the regs however... if a Hospital based group is reading for another imaging entity in another state and being paid at least the Medicare rate (not marked up) from the entity to perform their service, are there any circumstances which would allow the performing entity (technical provider) to bill Medicare globally for the imaging service? My understanding is the TC performing entity would need to always split bill Medicare to the respective MACs in the areas when the TC and PC services were provided - Ch 13 of the claims processing manual. Therefore the performing entity would need to be credentialed in both MACs to accommodate the split billing.

Does the above still hold true and again are there any remote reading arrangements that would allow for a global bill submission to Medicare where the technical service was provided?

Thanks in advance.

------------------------------
Richard Fleury
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Original Message------

Hello All:

​It's been a while since I've reviewed the regs however... if a Hospital based group is reading for another imaging entity in another state and being paid at least the Medicare rate (not marked up) from the entity to perform their service, are there any circumstances which would allow the performing entity (technical provider) to bill Medicare globally for the imaging service? My understanding is the TC performing entity would need to always split bill Medicare to the respective MACs in the areas when the TC and PC services were provided - Ch 13 of the claims processing manual. Therefore the performing entity would need to be credentialed in both MACs to accommodate the split billing.

Does the above still hold true and again are there any remote reading arrangements that would allow for a global bill submission to Medicare where the technical service was provided?

Thanks in advance.

------------------------------
Richard Fleury
------------------------------