In the Feb. 22 issue of the Federal Register, CMS published a final rule establishing a process for Medicare contractors to provide eligible participating physicians and beneficiaries with a determination of coverage relating to medical necessity for certain physicians’ services before the services are furnished. The rule is intended to give the physician and beneficiary a chance to know the financial liability for a service before expenses are incurred. The rule also establishes reasonable limits on physicians’ services for which a prior determination of coverage may be requested. The rule is effective March 24, 2008. Download the rule.
