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CMS-1403-FC
our general rulemaking authority under sections 1102(a) and
1871(a) of the Act, and authority under section 1842(b)(6)
of the Act, we amended the anti-markup provision in
§414.50. Specifically, we revised the anti-markup
provision to apply to the TC of diagnostic tests that are
ordered by the billing physician or other supplier (or
ordered by a party related by common ownership or control
to such physician or other supplier) when the TC is
outright purchased or when the TC is not performed in the
“office of the billing physician or other supplier.” We
revised §414.50(a)(2)(iii) to define the “office of the
billing physician or other supplier” as medical office
space where the physician or other supplier regularly
furnishes patient care. For a billing physician or other
supplier that is a physician organization, as defined at
§411.351, the “office of the billing physician or other
supplier” is space in which the physician organization
provides substantially the full range of patient care
services that the physician organization provides
generally. We also imposed an anti-markup payment
limitation on the professional component (PC) of diagnostic
tests that are ordered by the billing physician or other
supplier (or ordered by a party related by common ownership
or control to such physician or other supplier group) if
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