Health Care Financing Administration--Medicare program; reimbursement of hospital-based physicians. Rule, uniform implementation.
This Notice is to advise that HCFA will begin enforcing the regulations regarding Medicare reimbursement for services furnished by hospital-based physicians. It reaffirms the rule that identifiable professional services will be reimbursed under Part B on a reasonable charge basis only if: (a) The services require performance by a physician in person and (b) they contribute to the diagnosis or treatment of the patient. All other services performed by a hospital-based physician will be reimbursed to the hospital on a reasonable cost basis. This rule was established in a regulation published in 1966, after public comment, but has not been applied uniformly in recent years.
D007325:Institutional Practice; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D007357:Insurance, Physician Services / Q000331:legislation & jurisprudence; D008505:Medical Staff, Hospital; D006278:Medicare / Q000331:legislation & jurisprudence*; D014481:United States