Performance Standards
If providers are credentialing as an IDTF, then the performance standards shall be reviewed thoroughly before submitting a Medicare application. Refer to the IDTF Performance Standards and Attachment 2 beginning on page 39 of the CMS-855B.
The performance standards shall be met in order to obtain or maintain Medicare billing privileges. These standards, in their entirety, can also be found in 42 C.F.R, Section 410.33(g).
All codes reported must be for diagnostic tests that IDTFs are allowed to perform. This information is added in PECOS or on the CMS-855B.
Related Content
- CMS IOM Publication 100-01, Medicare General Information, Eligibility and Entitlement Manual, Chapter 5, Section 90.4
- CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 1, Section 30.2.6
- CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 35
- MLN® Booklet: Independent Diagnostic Testing Facility
- Federal Register 42 CFR Public Health 416.5, 410.33
Revised 11/16/2023