Medicare Archives

Medicare Limiting Charge Provisions

Limiting Charge Provisions for Non-participating Medicare Providers A limiting charge defines how much non-participating providers can charge Medicare patients. Chiropractic covered services (98940, 98941, and 98942) rendered by non-participating providers (those not accepting assignment) are still billed to Medicare. The patient must wait to be reimbursed by Medicare. The provider is only allowed to charge the…

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FAQ-Excluded Services in Medicare

Excluded Services in Medicare FAQs Q: According to Medicare, what is considered a statutorily excluded service when rendered by a Doctor of Chiropractic? A: A statutorily excluded service is a service the Medicare never covers when it is rendered by a Doctor of Chiropractic. This includes exams, x-rays, and physical therapy. The only service always…

Charging Appropriately for Medicare Services

Charging Medicare Patients Correctly As with any patient, providers are responsible for charging patients correctly and then accurately billing them or billing on their behalf. Because a provider may be participating or nonparticipating with Medicare, and because only a few services are actually covered by Medicare, the process is not straightforward. Here are the most…

Making Sense of Medicare Charge Rules

Medicare billing is very closely scrutinized so it’s important to get it right the first time. Remember, it’s not your decision whether to bill Medicare regardless of whether you’re participating or non-participating…that decision rests with the patient. This module walks you through the importance of using the right fee schedule, billing the right party, and…

Medicare Fee Schedule Resources

Download Reference Documents Medicare and the OIG publish helpful documents and alerts to keep providers in the know about important topics. The first document is a map of the A/B MAC Jurisdictions. The second is a brief summary of gifting in the chiropractic office and how inducement comes into the conversation of fees for Medicare…

FAQ-Medicare Fee Schedule

Medicare Fee Schedule FAQs Q: Where can I find my Medicare Fee Schedule? A: You can find the Medicare Fee Schedule on your Medicare Administrative Contractor’s (MACs) website. Many of the MACs offer a link on their home page that directs you to the fee schedule look-up tool. You need to know your enrollment status…