CMS Delays Certain Anti-Markup Provisions to January 1, 2009

January 3, 2008


The Centers for Medicare & Medicaid Services (CMS) announced a delay in the implementation date of most of the anti-markup provisions discussed in the Physician Fee Schedule Final Rule. The decision came after CMS review of informal comments on the proposed provisions from various stakeholders, including the Academy, that patient access to common diagnostic tests may be severely disrupted without a delay of the effective date of provisions relating to the professional component of provided services.

The anti-markup provisions that apply to purchased diagnostic tests and which have been in effect for a number of years remain effective January 1, 2008. In addition, the rule is not delayed for certain anatomic pathology services performed outside of the physician's office.

There are still many unanswered questions regarding the CMS anti-markup provisions. The Academy will keep you updated via the website and AANe-news as further guidance from CMS emerges on the stipulations.

Please contact Katie Kuechenmeister with questions.