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CMS-1403-FC
“outside supplier,” that the physician must be an employee
or independent contractor of the billing physician or other
supplier by incorporating the requirement into the
Alternative 2 criteria. Similarly, we believe that an
anti-markup payment limitation on purchased PCs is
unnecessary with respect to diagnostic testing services
that meet the requirements of Alternative 2, because we are
adding the requirement to Alternative 2 that the physician
performing the PC is an employee or independent contractor
of the billing physician or other supplier. Thus, as
finalized, we are deleting the references in §414.50 to
purchased tests and interpretations from an outside
supplier. As finalized, the anti-markup payment limitation
will apply to TCs and PCs that meet neither the
requirements of Alternative 1 nor Alternative 2, without
regard to whether the TC or PC was purchased from an
outside supplier.
Comment: A commenter requested that we clarify our
use of the term “conducted or supervised” because a
physician may “supervise” an imaging procedure, for
instance, even though he or she is not necessarily the
physician who will be interpreting a test. According to
the commenter, Medicare’s determination as to the level of
supervision required for a specific test supports this
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