What are Medicare Anti-Mark Up Rules?

Medicare’s new Anti-Mark up Rules went into effect on January 1, 2009.The Medicare Anti-Mark Up Rules are meant to prevent the mark up (price increase) of certain diagnostic tests that are conducted by outside suppliers and billed to Medicare by individuals or entities who do not share a practice with the patient’s physician. The rules limit how much outside entities such as diagnostic labs and pathologists can bill Medicare for diagnostic testing that was not done by a physician sharing a practice with the entity that is billing for the diagnostic tests. 

The information on this page is meant to provide a general overview of the law. The laws in your state and/or city may deviate significantly from those described here. If you have specific questions related to your situation you should speak with a local attorney.

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