tci General Surgery Coding Alert - 2007 Issue 9

Reader Question ~ 'One Size Fits All' Fee Schedule Isn't Required

Question: Must we bill all patients at the same rate?Pennsylvania Subscriber Answer: Technically, no, you don't have to bill all patients at the same rate. As long as you are following a contract or have consistent nondiscriminatory billing policies in writing, billing may vary from payer to payer. Just be sure to keep your billing policies consistent to avoid accusations of discrimination. In practice, however, you cannot charge more to Medicare patients than you charge to other patients. If you offer a lower rate for any given service or procedure to non-Medicare patients, you must offer the same...

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