Accreditation requirements and recommendations as mandated by the the Centers for Medicare & Medicaid Services (CMS) vary by testing area. Currently, CMS requires accreditation for all nonhospital providers of advanced diagnostic imaging, inclusive of Nuclear Medicine, MRI, CT and PET as part of the Medicare Improvements for Patients and Providers Act (MIPPA). At this time, CMS has not mandated a nationwide accreditation requirement for vascular testing and echocardiography studies, however, there are several states in which the Medicare carrier requires either accreditation of the facility and/or sonographer credentialing, for reimbursement of studies.
For complete CMS payment policy details, please visit the Reimbursement>>Payment Policies section of this website and click on the appropriate PDF to view the known payment policies for your testing area.
The following resources are provided to assist facilities in understanding what is required of their facility in regards to reimbursement from CMS:
- Published Federal Register: To download the published Federal Register containing the notice of CMS' approval of IAC for fulfillment of the accreditation requirement for advanced diagnostic imaging, please visit the Federal Registerwebsite at www.federalregister.gov, or download the Federal Register, Vol. 75, No. 16, Tues, January 26, 2010, Notices: Department of Health and Human Services | Centers for Medicare & Medicaid Services»
- Accreditation Requirements for Suppliers of the Technical Component of Advanced Imaging
- MIPPA FAQs (published by the IAC)
- CMS Advanced Diagnostic Imaging Accreditation Statutory Requirement Clarification
- Instructions for Entering Your Facility Identification Data in IAC Online Accreditation
Other CMS Resources
- Medicare Coverage Database: The Medicare Coverage Database (MCD) contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD decisions. Any details regarding accreditation requirements can be found by searching in this database for documents applicable to your testing area.
- Provider Compliance Group Interactive Map: The Provider Compliance Group Interactive Map allows you to access state-specific CMS contractor contact information.
- AB Medicare Administrative Contractor (MAC) – By State: This document lists the AB MAC contractors by state. Updated 1-2018