Author Topic: medicare part b billing  (Read 1763 times)

rdmoore2003

  • Hero Member
  • *****
  • Posts: 625
  • Live Life and Love God
medicare part b billing
« on: February 08, 2010, 02:33:48 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.
Regina

Pay_My_Claims

  • Guest
Re: medicare part b billing
« Reply #1 on: February 08, 2010, 03:50:21 PM »
more info please

rdmoore2003

  • Hero Member
  • *****
  • Posts: 625
  • Live Life and Love God
Re: medicare part b billing
« Reply #2 on: February 08, 2010, 04:07:49 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
Regina

DMK

  • Hero Member
  • *****
  • Posts: 680
Re: medicare part b billing
« Reply #3 on: February 08, 2010, 04:41:03 PM »
Is is part deductible and part co-pay?  It's still early in the year!

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4761
    • Solutions Medical Billing
Re: medicare part b billing
« Reply #4 on: February 09, 2010, 07:19:36 AM »
If it's not deductible it may be the Mental Health Deduction - Medicare only pays 50% on most MH dxs.

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

rdmoore2003

  • Hero Member
  • *****
  • Posts: 625
  • Live Life and Love God
Re: medicare part b billing
« Reply #5 on: February 10, 2010, 03:36:01 PM »
thanks Michele..
So far it looks as if Medicare has dropped to 45% on MH for 2010.
We will see.
Regina

PMRNC

  • Hero Member
  • *****
  • Posts: 4252
    • One Stop Resources & Networking for Medical Billers
Re: medicare part b billing
« Reply #6 on: February 13, 2010, 11:53:10 AM »
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
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

rdmoore2003

  • Hero Member
  • *****
  • Posts: 625
  • Live Life and Love God
Re: medicare part b billing
« Reply #7 on: February 23, 2010, 02:28:57 PM »
thanks so much Michelle.
Regina