獨立診斷測試設施應用信息
根據《聯邦法規》第 42 篇第 410.33 條，美國醫療保險和醫療補助服務中心，以及州醫療補助手冊，第 3490 至 3490.14 節，獨立診斷檢測機構 (IDTF) 提供者只有作為「僅限 Medicare 交叉」提供者才能註冊 Medi-Cal 計劃，從而獲得 Medicare B 部分服務的報銷。
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).