Medicare Pays for Some Inpatient Radiology and Pathology Services

The general Medicare rule about radiology and pathology services is that only the admitting hospital can bill for the technical component of service provided during an inpatient stay. 

Radiology suppliers that render services to beneficiaries in an inpatient stay may not bill the Medicare carrier for the technical portion of the service, nor may independent laboratories bill for pathology services provided to a Medicare inpatient.

The exception is that imaging and pathology services for Medicare beneficiaries performed by entities other than the admitting hospital on an inpatient's admission date and discharge date are separately payable. For further details, read  MLN Matters No. 5675 (PDF).

Reviewed March 5, 2014


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