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Mammography Regulation and Reimbursement Report (Single Article)

Radiology carve outs: Ask for what can be justified as unique and the increase will come
November 2004

Product Description:

A "carve out" in the payer world is defined as a group of current procedural terminology (CPT) codes that represent high utilization or unique outcomes by a provider. These codes are reimbursed at a rate higher than the other 20,000 or so codes on the physician practice fee schedule. A carve out also refers to codes that are not included-they are literally carved out-of the contractual agreement by the payer, such as laboratory or radiology services.

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