Helpful Billing Information

The following links will provide information regarding Medicare billing and reimbursement for PET procedures. Billing and Reimbursement polices for private payers vary considerably from Medicare. Some private payers may rely on Medicare reimbursement as the basis; many others will have exclusive guidelines to follow for reimbursement. To obtain proper guidance on coverage polices, you should contact the payer directly or visit their Web site.
Medicare billing processess and recent changes
CMS-release database for retrieval of program memoranda, Provider-based entity descriptions, and start-up documentation requirements.
Click here for more information
Electronic Billing and EDI Information
National Provider Identifier Standard (NPI)
National NPI lookup
Hospital Outpatient Prospective Payment System (HOPPS):
Overview of CMS Final Rules regarding HOPPS
CMS Prospective Payment System (PPS) pricing information and calculator
Current Medicare PET and PET/CT codes:
CMS CR5665, current revised information on PET Scan codes and Radiopharmaceutical Diagnostic Imaging Agents Codes Applicable for PET Scan Services Performed on or After January 7, 2008 can be found by clicking here.
Click here for additional information
Medicare Carriers Local coverage determination (LCD) for PET Scans by state:
Including additional information such as modifiers, RVUs, exclusions, limitations, contact information and fee schedules. Select state and you will be directed to the carrier’s Web site.
Click here for more information
CMS Final National Coverage Determination (NCD) for Positron Emission Tomography (PET) Scans:
Click here to view the NCD for PET scans on the CMS Web site
Medicare Claims Processing Manual, Chapter 13; Section 60 – PET Scans
Medicare Claims Processing Manual, Transmittal 923, April 28, 2006
Update of Radiopharmaceutical Imaging Agents HCPCS Codes Applicable to PET Scan Services for Carriers
Part A Intermediaries and Part B Carriers by State
National database for UPIN lookup
Visit the NOPR PET Registry Web site for all forms and educational material
CMS Claims processing manual for CMS approved Clinical Trial (NOPR)
Listings of current PET and PET/CT CPT codes and other information will be listed here soon. Please check back.
As a service to our customers, we will do everything we can to help you with your insurance and billing needs. These services may include:
Medicare National and local coverage determination
Scheduling process and sample forms
CPT and HCPCS Codes
Billing guidelines
Covered Indications
Contracting Issues
If you need additional information that was not found on our Web site or have questions, please contact us via email at the email address listed below
Mark Coahran, Vice President, Sales & Development
(719) 282-1858
Email Mark

Front Range Mobile Imaging, Inc.
418 East College Drive
Cheyenne, Wyoming 82007