독립 진단 검사 시설 신청 정보
미국 연방규정집(CFR) 제42편 제410.33조에 따라, 메디케어 및 메디케이드 서비스 센터, 그리고 주 메디케이드 매뉴얼, 섹션 3490부터 3490.14까지, 독립 진단 검사 시설(IDTF) 제공업체는 메디케어 파트 B 서비스에 대한 상환을 받기 위해 "메디케어 크로스오버 전용" 제공업체로만 메디칼 프로그램에 등록할 수 있습니다.
Independent Diagnostic Testing Facilities are required to submit their application via PAVE (Provider Application and Validation for Enrollment).
1. Federal Employer Identification Number (FEIN) or Individual Taxpayer Identification Number (ITIN) verification, if a social security number is not used, by submitting a current Internal Revenue Service (IRS) generated document. The only acceptable documents include an IRS-generated Letter 147-C, IRS-generated Form 941 (Employer’s Quarterly Federal Tax Return), IRS-generated Form 8109-C (Deposit Coupon), or IRS-generated Form SS-4 (only the official Confirmation Notification of FEIN/ITIN assignment). Note: The legal name of the applicant or provider on the application must exactly match the name on the IRS-generated document; and the applicant/provider must be an owner or officer of the entity listed on the IRS document. For further information, please visit the IRS or call them at (800) 829-4933.
2. Copy of approval letter as an Independent Diagnostic Testing Facility (IDTF) provider from the Centers of Medicare and Medicaid Services (CMS).