Diagnostic Test
A “diagnostic test” includes all diagnostic x-ray tests, all diagnostic
laboratory tests, and other diagnostic tests furnished to a beneficiary.
Treating Physician
A “treating physician” is a physician, as defined in §1861(r) of the Social
Security Act (the Act), who furnishes a consultation or treats a beneficiary
for a specific medical problem, and who uses the results of a diagnostic test
in the management of the beneficiary’s specific medical problem.
A radiologist performing a therapeutic interventional procedure is considered a
treating physician. A radiologist performing a diagnostic interventional or
diagnostic procedure is not considered a treating physician.
Treating Practitioner
A “treating practitioner” is a nurse practitioner, clinical nurse specialist,
or physician assistant, as defined in §1861(s)(2)(K) of the Act, who furnishes,
pursuant to State law, a consultation or treats a beneficiary for a specific
medical problem, and who uses the result of a diagnostic test in the management
of the beneficiary’s specific medical problem.
Testing Facility
A “testing facility” is a Medicare provider or supplier that furnishes
diagnostic tests. A testing facility may include a physician or a group of
physicians (e.g., radiologist, pathologist), a laboratory, or an independent
diagnostic testing facility (IDTF).
