Author Topic: Radiology Billing for Medicare and Medicaid  (Read 951 times)

dolphy

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Radiology Billing for Medicare and Medicaid
« on: October 20, 2010, 10:24:33 PM »
.  For Medicare, Medicaid x-rays; our company bills the "global rate" this rate incorporates the transport, setup, the study and the radiologist read fees.   My question is, for patients who are in a nursing home (skilled Nursing Facility) on a Medicare part A stay where we normally direct bill the facility for the x-ray rather than Medicare, can the radiologist read fee be billed separately to Medicare?  If so is there any special agreement that needs to be in place?  Special modifier? The same question goes for Medicare and Medicaid patients in a long term acute care hospital. For patients in a long term acute hospital, we bill all x-rays and services done for that hospital, directly to that hospital.
I hope someone has an answer  :)

oneround

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Re: Radiology Billing for Medicare and Medicaid
« Reply #1 on: October 27, 2010, 05:52:43 PM »
Hi Michael,

 Hi Michael,

 
The Read fee should be no different then the MD billing the “professional component” is billed separately/directly to Medicare by the provider.

Hope this helped

 



 
 

Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare