Ask Dr. Z

This appears to suggest that same group practice providers can bill under one provider. Is this accurate and would it apply to stress test 93016? Doc A orders/interprets-Doc B supervises. Can we bill 93015 under doc A? POS11

20.3.1 – A/B MAC (B) Payment Rules

(Rev. 1931, Issued: 03-12-10, Effective: 06-14-10, Implementation: 06-14-10)

If a diagnostic test (other than a clinical diagnostic laboratory test) is personally performed or is supervised by a physician, such physician may bill under the normal physician fee schedule rules. This includes situations in which the test is performed or supervised by another physician with whom the billing physician shares a practice (see Pub. 100-04, chapter 1, §30.2.9). Section 80, chapter 15, of Pub. 100-02, Medicare Benefit Policy, sets forth the various levels of physician supervision required for diagnostic tests. The supervision requirement for physician billing is not met when the test is administered by supplier personnel regardless of whether the test is performed at the physician's office or at another location.