Medicare Claims Processing Manual (Pub. 100-04), Ch. 18 § 20.3
Payment
20.3 - Payment
(Rev. 3844, Issued: 08-18-17, Effective: 01-01-18, Implementation: 01-02-18)
There is no Part B deductible or coinsurance for screening mammographies. The anti-markup
payment limitation on physician billing for diagnostic tests does not apply to these services.
Following are three categories of billing for mammography services:
•
Professional component of mammography services (that is the physician’s interpretation of
the results of the examination);
•
Technical component (all other services); or
•
Both professional and technical components (global). However, global billing is not
permitted for services furnished in provider outpatient departments, except for CAHs
electing the optional method of payment for mammography services furnished on or after
January 1, 2002.