Disclosure Requirement for the In-Office Ancillary Services Exception (CMS-10332)

In order to implement section 6003 of the Affordable Care Act, CMS has proposed to amend 42 C.F.R. 411.355(b). Section 6003 establishes a new disclosure requirement for physicians who refer magnetic resonance imaging, computed tomography, and positron emission tomography (MRI, CT and PET) under the in-office ancillary services exception to the prohibition on physician self-referral (section 1877 of the Social Security Act). Under this new requirement physicians must inform patients in writing, at the time of the referral, that the patient may receive the imaging service from another supplier. The physician must also provide the patient with a list of other suppliers that from whom the patient may obtain the services. The proposed rule provides detail regarding what criteria must be included in the disclosure notifcation and supplier list in order to satisfy this new requirement.

The latest form for Disclosure Requirement for the In-Office Ancillary Services Exception (CMS-10332) expires 2027-10-31 and is listed under ICR 202407-0938-013.

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Federal Enterprise Architecture: Health - Health Care Services