UnitedHealthcare will now require all outpatient medical imaging providers to apply for accreditation from the American College of Radiology (ACR) or another accrediting body, by the fourth quarter of 2009 to receive reimbursement for CT, MRI, PET, nuclear medicine, nuclear cardiology and echocardiography services.
UnitedHealthcare originally intended to require accreditation as a condition for reimbursement beginning in the third quarter of this year. However, the payor adjusted its timeline based on feedback from physicians and other imaging stakeholders, which indicated that some communities may not have a sufficient number of accredited facilities to meet patient and physician needs, according to the ACR.
Additionally, the recent implementation of the Medicare Improvements for Patients and Providers Act, requiring providers of advanced imaging services to be accredited by Jan. 1, 2012, influenced UnitedHealthcare’s decision.
By 2012, accreditation will be a mandatory requirement to receive payment for the technical component of imaging services. In the meantime, the insurer has indicated that it will continue to promote and encourage the use of accredited imaging facilities to referring physicians and its members.
The ACR reported that it stands ready to help providers meet the insurer’s accreditation standard.