The CMO Radiology Privileging Program took effect on 4/15/07. The privileging program has been designed to ensure that imaging services are provided in the most appropriate setting.

What does this mean for your office?

Effective 4/15/07, CMO will only reimburse imaging claims submitted by providers who:

a) are listed as a privileged specialty in the Program and;
b) have submitted an imaging claim within the approved CPT codes for his/her specialty.

Enclosed you will find a listing of procedure codes impacted by the program. If you perform any of these procedures, please review the Privileging Specialty List that identifies the medical specialties and imaging services that may be performed in the office or other outpatient setting. If your clinical specialty is not listed, with the exception of Radiologist, ER, and Critical Care, you will not be reimbursed for any imaging services. The denial, "D64- Specialty not certified for imaging services," will appear on the explanation of benefits (EOB).

Please contact your CMO liaison or the CMO Provider Relations department at 914-377-4477 to address any concerns. We appreciate your support and look forward to your assistance in ensuring that your patients continue to receive high quality diagnostic imaging services.