Medicare Coverage Analysis

Medicare Coverage Analysis (MCA) is required for all clinical research studies in which tests, procedures, and interventions associated with the research can potentially be billed to third party payers or subjects. The MCA must be performed prior to enrolling subjects and initiation of clinical research procedures to assure proper billing of services.

Medicare covers the routine costs of qualifying clinical trials (per National Coverage Determination for Routine Costs in Clinical Trials, 310.1) and reasonable and necessary items and services used to diagnose and treat complications arising from participation in clinical research.

Additional Information: UAMS Administrative Guide 16.1.09: Research Registration and Billing.