June 23, 2003

Dear Portable X-ray Supplier:

Please refer to the enclosed notice regarding a rate review being conducted by Empire Medicare Services for transportation of portable x-ray equipment and personnel (R0070). If you have questions regarding this notice, please contact me at the address listed on the enclosure.

Sincerely,

Trish Diendorf

Provider Reimbursement

Enclosure

In accordance with Program Memorandum B-02-075, Change Request 2421, each Medicare carrier is required to determine and periodically review the payment amounts for portable x-ray transportation services for the geographic areas within its jurisdiction.

In order to consider a revision of the current payment rate, Empire Medicare Services must determine the cost of providing this service. We will be considering direct costs such as: cost of the vehicle, the salary and fringe benefits associated with the staff who drive the vehicle, the communication equipment used between the vehicle and the home office, the salary and fringe benefits of the staff who determine the vehicle’s route, repairs and maintenance of the vehicle(s), insurance for the vehicle(s), and operating expenses for the vehicle(s).

Suppliers may send cost information, which we may use as a comparison to our pricing determination. The data supplied should reflect a year’s worth of information.

Any portable x-ray supplier that would like to furnish information that would assist us in our cost analysis may send the data to:

New York suppliers:

Empire Medicare Services NY

P.O. Box 1200

Crompond, NY 10517-1200

New Jersey suppliers:

Empire Medicare Services NJ

Provider Reimbursement Dept.

P.O. Box 69218

Harrisburg, PA 17106-9218