Radiology - JE Part A

Medicare generally covers: x-rays, including portable x-rays, fluoroscopy and mammography; CT, including portable CT, CT angiography (CTA) and CT-guided procedures; MRI, including MR angiography (MRA) and MRI-guided procedures; ultrasound (US), including diagnostic grey-scale and vascular Doppler imaging, and US-guided procedures; nuclear medicine diagnostic imaging and procedures, including radionuclides and PET for certain conditions; radiation oncology; and bone density (DEXA) scans. Coverage may be limited to certain indications.

Medicare covers imaging services that are performed or supervised by a physician who is certified or eligible to be certified by the American Board of Radiology or for whom radiology services account for at least 50 percent of the total amount of charges made under Medicare.

Access the below related information from this page.

• Billing Radiology Services Professional and Technical Components
• Diagnostic Tests: Purchased or Personally Performed
• Interventional Radiology
• Multiple Procedure Payment Reduction on Certain Diagnostic Imaging Procedures
• Portable X-Ray Transportation Suppliers Billing and Coding Guidelines

Resource

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 13
• CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 80
• CMS Change Request (CR) 6371 - Diagnostic Tests Subject to Anti-Markup Pricing