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Regulations



 
9789.17.1....Radiology Diagnostic Imaging Multiple Procedures
(a) Specified diagnostic imaging procedures are designated in the “Diagnostic Imaging Service Subject to the Multiple Procedure Payment Reduction (MPPR)” file ...more
 
 
9789.17.2....Radiology Consultations
This interpretation of an x-ray procedure must directly contribute to the diagnosis and treatment of the patient. The physician must prepare a signed written report of ...more
 
 
9789.17.3....Additional Payment Reductions for Certain Diagnostic Imaging Services
(a) For services rendered on or after March 1, 2017, payment of X-ray imaging services that are taken using film is made at:   (1) 80 percent of a technical ...more
 
 
9789.18.1....Payment for Anesthesia Services - General Payment Rule
The fee schedule amount for physician anesthesia services is, with the exceptions noted, based on allowable base and time units multiplied by an anesthesia conversion ...more
 
 
9789.18.10....Anesthesia - Monitored Anesthesia Care
The physician or non-physician practitioner shall be reimbursed for reasonable and medically necessary monitored anesthesia care services on the same basis as other ...more
 
 
9789.18.11....Anesthesia Claims Modifiers
Physicians shall report the appropriate anesthesia modifier to denote whether the service was personally performed, medically directed, or medically supervised in ...more
 
 
9789.18.12....Anesthesia and Medical/Surgical Service Provided by the Same Physician
When these services are performed by the second physician in the nonfacility setting, CPT codes 99148 to 99150 are not to be reported.   (c) If the anesthesiologist or ...more
 
 
9789.18.2....Anesthesia - Personally Performed Rate
The anesthesia fee calculation will recognize the base unit for the anesthesia code and one time unit per 15 minutes of anesthesia time in any of the following ...more
 
 
9789.18.3....Anesthesia - Medically Directed Rate
  (b) The physician must participate only in the most demanding procedures of the anesthesia plan, including, if applicable, induction and emergence. Physicians must ...more
 
 
9789.18.4....Anesthesia - Definition of Concurrent Medically Directed Anesthesia Procedures
Concurrency is defined with regard to the maximum number of procedures that the physician is medically directing within the context of a single procedure and whether ...more
 
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