Author Topic: medicare part b billing  (Read 3441 times)

rdmoore2003

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medicare part b billing
« on: February 08, 2010, 05:33:48 PM »
Medicare says pt responsibility is 20% of allowed amount.
For 2010 fee schedule, their 20% is not adding up. 
(it is the day after superbowl and my mind is frozen)
Please help.

Pay_My_Claims

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Re: medicare part b billing
« Reply #1 on: February 08, 2010, 06:50:21 PM »
more info please

rdmoore2003

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Re: medicare part b billing
« Reply #2 on: February 08, 2010, 07:07:49 PM »
ok here is the situation  - 2010 medicare fee schedule-  par provider

  a new eob is showing:

90804  allowed amount $59.79
paid provider $32.89
pt responsible $26.90

by my calculations, this does not add up to show 20%
please help

DMK

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Re: medicare part b billing
« Reply #3 on: February 08, 2010, 07:41:03 PM »
Is is part deductible and part co-pay?  It's still early in the year!

Michele

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Re: medicare part b billing
« Reply #4 on: February 09, 2010, 10:19:36 AM »
If it's not deductible it may be the Mental Health Deduction - Medicare only pays 50% on most MH dxs.

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Re: medicare part b billing
« Reply #4 on: February 09, 2010, 10:19:36 AM »

rdmoore2003

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Re: medicare part b billing
« Reply #5 on: February 10, 2010, 06:36:01 PM »
thanks Michele..
So far it looks as if Medicare has dropped to 45% on MH for 2010.
We will see.

PMRNC

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Re: medicare part b billing
« Reply #6 on: February 13, 2010, 02:53:10 PM »
The payment is correct. MH is 55% this year as part of Medicare's Phase out plan for 2010-2014: In 2010 and 2011, Medicare will reimburse for just 55 percent of psychiatric services. Not until 2014 will reimbursement reach the standard 80 percent.

Quote
90804  allowed amount $59.79
paid provider $32.89
pt responsible $26.90

59.79 X 55% = 32.89
Linda Walker
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rdmoore2003

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Re: medicare part b billing
« Reply #7 on: February 23, 2010, 05:28:57 PM »
thanks so much Michelle.

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Re: medicare part b billing
« Reply #7 on: February 23, 2010, 05:28:57 PM »