Intensity-Modulated Radiation Therapy (IMRT) Planning Services Editing

Published 09/12/2018

This MLN Matters® Special Edition Article (SE18013) provides a reminder to hospitals that bill for outpatient Intensity-Modulated Radiation Therapy (IMRT) planning services to ensure that they bill correctly and avoid overpayments. IMRT is a procedure that delivers radiation with adjusted intensity to preserve adjoining normal tissue. IMRT is provided in two treatment phases, planning and delivery. Medicare pays hospitals under the OPPS a bundled payment for the planning phase. The bundled payment covers a range of services that may be performed as part of developing an IMRT treatment plan. The bundled payment covers these services regardless of when they are billed.