Billing and Collections

Ask the Experts: MRI Billing

January 17, 2019 9:32 am

Are there opportunities to bill for a freestanding MRI/CT center using a UB04 claim form instead of 1500 claim form? Any advantages?


Answer 1: I would recommend the provider contact its local Medicare Administrative Contractor (MAC). In order to bill a global fee, I believe a 1500 claim form is required. 

This question was answered by: Caswell Samms, III, vice president and CFO, WellStar Kennestone, and a member of HFMA’s Georgia Chapter.

Answer 2: The type of facility designation makes a difference. To bill on the UB04/8371 equivalent, a bill type should be designated to identify the type of provider. There is a code for a freestanding clinic 073X. There is no bill type for a freestanding MRI/CT center specifically.

This question was answered by: Suzanne Lestina, FHFMA, CPC, director of administrative simplification policy, American Hospital Association, and a member of HFMA’s First Illinois Chapter.

What do you think? Please share your thoughts on this question in the comments section below.  

The information provided through the Forum’s Ask the Expert service does not constitute legal advice, even when the advice is provided by lawyers. You need to obtain your own legal counsel for legal advice and consider the laws and regulations that govern your state. The content and opinions expressed are those of the Forum experts, and not that of their employers or of HFMA. HFMA does not endorse the material or warrant or guarantee its accuracy. The responses are based only on the specific facts or circumstances provided. Forum experts cannot be held liable for outcomes related to any information provided.

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