独立诊断测试设施申请信息
根据《联邦法规》第42篇第410.33节，美国医疗保险和医疗补助服务中心，以及州医疗补助手册，第 3490 至 3490.14 节，独立诊断检测机构 (IDTF) 提供商只有作为“仅限 Medicare 交叉”提供商才能注册 Medi-Cal 计划，从而获得 Medicare B 部分服务的报销。
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).