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…
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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…
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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…
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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…
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Additional Rules and Options for Statutorily Excluded Services The only services covered under Medicare when ordered or delivered by a chiropractor are the three spinal adjustment codes (98940, 98941, 98942). These codes are only covered when Medical Necessity is met; otherwise, the patient is considered in the maintenance phase of care. When a patient transitions…
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Review of Medicare Fee Schedule for Non-Participating Providers When a provider chooses to be Non-participating with Medicare, it is not the equivalent of being out of network with other carriers. Unlike the participating provider, a Non-participating provider should only bill Medicare according to the Medicare fee schedule. If actual fees are sent to Medicare, the…
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