CMS issued a final rule February 22 establishing a process for Medicare contractors to provide eligible participating physicians and beneficiaries with a determination of coverage before certain physicians’ services are furnished, as mandated by the Medicare Modernization Act of 2003 (MMA). The prior determination process may be used for the most expensive physicians’ services that are performed at least 50 times annually, along with Medicare-covered plastic and dental surgeries that have a reimbursement amount of at least $1,000. The rule is effective March 24, 2008.
