An ancillary service is a type of medical procedure performed in the physician’s office. The referring physician must be part of the group practice to qualify. A referring physician must have a certain level of expertise to provide the service, and the services must be provided in the same building. IOASE protects in-office ancillary arrangements and prohibits self-referrals. While some of these services may not be covered under the Stark Act, the in-office auxiliary service exception may still be in effect.
There are several exceptions to the general rule about in office ancillary services. The most notable exception is that in office ancillary services can be performed by another physician, who is a member of the same group. The “in-office auxiliary services” exception does not apply to services performed in the same building as the referring physician. A few examples of in-office ancillary services include:
For an in-office ancillary service to qualify, a physician must deliver all designated health services in the same location. The practice can share furnishings and office space, but independent contractors must provide supervision and dictation, and billing must be provided by the same entity. An independent contractor cannot be paid by a fee based on the number of hours spent in the office. A multi-physician practice is not eligible for the exception, but a single office can be used to provide related services.
In-office ancillary services are not required for Medicare. The exception applies to physicians who are part of a group practice. The in-office ancillary services exception is only applicable to groups. However, in-office ancillary services can be eligible for Medicare benefits. A physician can refer an eligible patient to these services as part of their overall compensation and benefit plan. In addition, the in-office ambulatory care may be an essential part of an individual’s health.
In-office ancillary services are not excluded from the Stark law. In-office ancillary services can be covered by the exception if the in-office medical service has a statutory exemption. The new laws also protect “physician referral” and other in-office medical practices that receive a referral from a health care professional. For example, a pain management specialist may refer patients to a diagnostic service.
A physician can offer in-office imaging services to their patients. Physical therapy and imaging are also important to the health of the patient. The ability to diagnose musculoskeletal conditions quickly is vital for preventing future injuries. An accurate diagnosis is the most effective way to restore a patient’s mobility. If a doctor is unable to give a patient the right diagnosis, physical therapists may have trouble providing appropriate physical therapy.
The Stark Law’s in-office ancillary services exception is the exception to the rules for Medicare reimbursement. The in-office ancillary services exception helps a physician coordinate care by providing additional services. For example, a physician can provide imaging services to patients when needed. Likewise, a doctor can provide diagnostic tests, perform diagnostic procedures, and monitor the patient’s health. Further, a patient can have multiple visits with a urologist to receive a more accurate diagnosis.
In-office ancillary services are an important component of physician practices. In-office ancillary services can range from specialized care to the provision of supplies. The IOASE bill is a part of a physician’s personal professional services. It allows a doctor to provide structured PT arrangements with auxiliary personnel. The IOAS study included only 5% of a population of Medicare fee-for-service enrollees.
IOASE requires a physician to certify the need for ancillary services. In-office ancillary services are a critical part of a physician’s practice. If they are performed in the same building as the physician’s office, then a physical therapist can meet the requirements of the Stark law. As a result, physicians are able to provide in-office ancillary services without a physician.