The Centers for Medicare & Medicaid Services (CMS) has rescinded Transmittal #187 (Change Request 5449), which provided new, detailed, and more rigid guidelines for independent diagnostic testing facilities (IDTFs) enrolling or re-enrolling as Medicare providers.

CMS asked its contractors to discard all materials related to CR 5449 and apologized for any inconvenience the instructions may have caused. The additional language added by CMS to this transmittal, which was to have been implemented in an unusually short 30-day timeframe on February 26, appeared to exceed CMS' authority. Also, it is clear that CMS was not aware of the implications this transmittal would have for radiology practices.

The proposed changes for IDTFs, as originally listed in the Medicare Physician Fee Schedule final rule, were of no major concern and were something the ACR supported (link to ACR comment letter). However, Medicare apparently decided later to add additional restrictions on IDTFs in the transmittal. These restrictions related to sharing of space and leasing arrangements, banning of retroactive billing while the IDTF waits for its approval from Medicare, and requiring the use of full-time W-2 radiology technologists to provide the imaging studies.
The ACR was very concerned that these additional requirements were not listed in the notice of proposed rule making and would have been close to impossible for radiology practices and IDTFs to meet in a one-month timeframe. The ACR believes that these additional changes are serious enough that they should have been posted in a notice of proposed rule making and made available for public comment. The National Coalition for Quality Diagnostic Imaging Services (NCQDIS), which represents a large portion of the IDTF community, brought these issues to the attention of CMS, which resulted in the agency pulling back its transmittal.

While CMS has rescinded CR5449, IDTFs must still meet the performance standards as outlined in the Final Rule and codified in the electronic Code of Federal Regulation. Therefore, it is important that all IDTF sites be familiar with these requirements.

CMS has asked that anyone interested in commenting on the IDTF standards and requirements submit their comments to CMS in writing. CMS has not decided at this time whether it will issue further guidance in regulations or through a transmittal.

For a discussion of the 14 performance standards and requirements of IDTFs, which remain effective as of 1/1/07, please refer to the ACR article "New Performance Standards for Independent Diagnostic Testing Facilities" in the January/February 2007 ACR Radiology Coding Source™ due out the end of February.

Back to HCB News

More Industry Headlines