CMS Requirements

To Our Referring Providers:

Great Lakes Medical Imaging’s radiology practices have collaborated to bring this important issue to your attention.

CMS recently published a transmittal that provides specific requirements associated with authenticating orders for tests. To encourage and implement best practice for our orders, we will be utilizing these guidelines for all payors. In confirming its position, CMS specifically states:

“For medical review purposes, Medicare requires that services provided/ordered be authenticated by the author. The method used shall be a handwritten or an electronic signature. Stamp signatures are not acceptable.”

CMS also requires that orders presented from the treating physician or non-physician practitioner (NPP) be signed (either handwritten or electronic) by that treating physician or NPP. This pertains to radiology exams paid by the physician fee schedule or the Outpatient Prospective Payment System that require a physician to provide the diagnostic reading. The CMS updated policy regarding test orders reads:

“a written order for diagnostic tests… [for example, that are paid under the Physician Fee Schedule (PFS) or under the Outpatient Prospective Payment System (OPPS)], such as X-rays, MRIs,… must be signed by the ordering physician, NP, or PA.”

Acceptable forms of signature include:

  • Legible handwritten signature
  • Illegible handwritten signature, but only if the illegible signature can be confirmed on the order a) Typed or printed name underneath the illegible signature or initials b) Prescription pad with providers listed and the specific ordering provider circled
  • Electronic or digitized signature containing a printed validation statement and date and time stamp a) “Electronically signed by (physician, NP, or PA) on (date) at (time)”

This information is being presented to you for your convenience. Orders that are not authenticated by the author in one of the acceptable formats listed above will be deemed non-reimbursable. CMS auditors, such as CERT, RAC, Carrier, and MAC auditors, will be ensuring we adhere to the above guidelines in their audits.

You may obtain more information on CMS’s position by accessing the following documents online:

We collectively request that you comply with this CMS requirement by properly authenticating your orders to avoid unnecessary burden to your patients. We would have to delay the diagnostic test ordered while we reached out to you for a properly documented and signed order.

We thank you in advance for your attention to this urgent matter.


Great Lakes Medical Imaging




199 Park Club Lane, Suite 300
Williamsville, NY 14221
Phone: 716-836-4646
Fax: 716-836-4696
Open 1.2T High Field MRI/1.5T High Field MRI/PET-CT Scan/Nuclear Medicine/Low Dose CT Scan/X-ray/Fluoroscopy (Bariatric)/Bone Densitometry/Mammography/Ultrasound


3850 Saunders Settlement Road Suite 150
Cambria, NY 14132
Phone: 716-898-2840
Fax: 716-898-2845
CT Scan/Ultrasound/X-ray


3085 Harlem Road Suite 150
Cheektowaga, NY 14225
Phone: 716-844-5300
Fax: 716-844-5340
1.5T High Field MRI/Low Dose CT Scan/

Orchard Park

500 Sterling Park Suite 150
Orchard Park, NY 14127
Phone: 716-362-1545
Fax: 716-362-1584
CT Scan/Ultrasound/X-ray

5959 Big Tree Road Suite 105
Orchard Park, NY 14127
phone 716-256-1114
fax 716-256-1115
3T MRI / CT (128) / X-ray / Ultrasound


Middletown-Orange High Field

Middletown, NY 10941-4040
Phone (845)673-6446
Fax (845)673-6449
1.2 High Field Open MRI

New Hartford-Open MRI of Mohawk Valley

4693 Commercial Drive
New Hartford, NY 13413-6209
Phone (315)507-5144
Fax (315)507-5147
Open MRI

Please call each office for specific service hours.

For Billing inquiries please call
Phone: 716-332-8078
Payment plans available.