- Improper Payment for Intensity-Modulated Radiation Therapy Planning Services
In a recent report, the Office of Inspector General (OIG) determined that payments for outpatient Intensity-Modulated Radiation Therapy (IMRT) did not comply with Medicare billing requirements. Specifically, hospitals billed separately for complex stimulations when they were performed as part of IMRT planning. Overpayments occurred because hospitals are unfamiliar with or misinterpreted CMS guidance.
Use the following resources to bill correctly:
- IMRT Planning Services Editing MLN Matters® Article
- Medicare Improperly Paid Hospitals Millions of Dollars for IMRT Planning Services OIG Report, August 2018
- Medicare Claims Processing Manual, Chapter 4, Section 200.3.1
- July 2016 Update of the Hospital Outpatient Prospective Payment System MLN Matters Article