Do You Charge Your Medicare Advantage Patient the Medicare Limiting Fee?

November 1, 2024

Hot Topics from the KMC University Helpdesk

Myth or Truth:

You Must Charge Your Medicare Advantage Patient the Medicare Limiting Fee When You Are Not Contracted with Their Plan

Why do so many people have their hands in the pot of your office pocketbook? Ensure you know the rules for charging Medicare Advantage patients when you are out of network with their plan. It may seem like you should be able to do your own thing. Medicare Regulations are clear on this topic. Check this video out to learn more about charging Medicare Advantage patients for their medically necessary spinal CMT services. We’ve seen the other side of this with a KMC University client. They can and will enforce this.

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