sparkles1077
Guru
How would you answer this question?
Question from a rural hospital about the extent to which hospitals can bill Medicaid for the professional component of an radiology service preformed by out of state radiologists. Here is the scenario.
•Hospital contracts with out of state radiology group
•Radiologists are licensed in state (same state hospital bills from)
•Radiologists are enrolled in Medicaid
•Hospital has credentialed radiologists to read digital images
•Hospital is a rural facility and does not have any in-state radiologists on its medical staff
•When the hospital bills Medicaid (for example, for a chest x-ray performed at the hospital and then read remotely by one of these radiologists), the hospital includes a modifier on the billing code that indicates it is billing for both the technical and professional component
Question from a rural hospital about the extent to which hospitals can bill Medicaid for the professional component of an radiology service preformed by out of state radiologists. Here is the scenario.
•Hospital contracts with out of state radiology group
•Radiologists are licensed in state (same state hospital bills from)
•Radiologists are enrolled in Medicaid
•Hospital has credentialed radiologists to read digital images
•Hospital is a rural facility and does not have any in-state radiologists on its medical staff
•When the hospital bills Medicaid (for example, for a chest x-ray performed at the hospital and then read remotely by one of these radiologists), the hospital includes a modifier on the billing code that indicates it is billing for both the technical and professional component