Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 120
Payment to Non-Indian Health Service Physicians by Indian
120 - Payment to Non-Indian Health Service Physicians by Indian
Health Service (IHS) Providers for Teleradiology Interpretations
(Rev. 1643, Issued: 12-05-08, Effective: 01-01-07, Implementation: 03-09-09)
The IHS providers may choose to purchase or otherwise contract for teleradiology
interpretation from non-IHS practitioners. Two options are available for payment for
these services.
(1) Contractual Reassignment - Under this provision, non-IHS physicians can
reassign their benefits to the IHS hospital where the technical component is
performed. Non-IHS practitioners providing these services shall enroll with the
designated A/B MAC contractor for IHS and complete a Form CMS-855-R form
for each IHS hospital performing the test. Because of IHS status, state licensure
and location of the physicians is not an issue and the designated A/B MAC
contractor shall make payment based on the Medicare locality in which services
are rendered in accordance with current jurisdictional pricing guidelines (see
§80.2, paragraph 6 of this Chapter).
Purchased Test - The purchased test method is available for all purchased diagnostic tests
including radiology, and the requirements are found in Chapter 1. Payment for
teleradiology interpretations under the purchased test option does not require non-IHS
physicians’ enrollment with the designated A/B MAC contractor for IHS. All general
jurisdictional and pricing rules apply for payment for these services.