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CMS-1403-FC
requirements of the Alternative 2 “site-of-service”
approach may fit under the requirements of the Alternative
1 “substantially all” professional services approach.
g. Services Performed at a Site Other Than the Office of
the Billing Physician or Other Supplier
Comment: A commenter offered strong support for the
proposed clarification that “if the TC is conducted outside
the office of the billing physician or other supplier, the
anti-markup provision applies irrespective of whether the
supervision takes place in the office of the billing
physician or other supplier.” The same commenter also
supported our proposal that the anti-markup payment
limitation would apply if “either the conducting of the TC
or the supervising of the TC takes place outside the office
of the billing physician or other supplier.” Another
commenter supported the proposed change that the anti-
markup payment limitation would apply if the TC is either
conducted or supervised outside the office of the billing
physician or other supplier in order to eliminate confusion
among providers when determining whether the TC is deemed
to be provided by an outside supplier for purposes of the
anti-markup provisions. Another commenter expressed
concern that the TC will be considered to be performed
outside the office of the billing supplier if the physician
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