Medical Billing Forum
Payments => Patient Billing => : billingfromhome428 March 31, 2009, 05:41:33 PM
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Can you bill a Medicaid patient for chiropractic services once they have maxed their benefits?
I don't think you can, but I thought I would ask to make sure I wasn't writing something off that could be rolled to the patient!
Thanks!
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Yes, if you inform them in writting prior to services being rendered. (NC Medicaid law) I can only speak on that.
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I didn't think Medicaid covered chiro! They don't in NY.
Michele
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It does in NC.
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They haven't covered chiro in NY for as long as I've been billing. I've always assumed no state Medicaid covered chiro. Do they pay decent? (Decent for Medicaid) Wow, you learn something new everyday, I can go to bed now. :)
Michele
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The Medicaid fee schedule for Illinois shows $10.67 for each level of adjustment for FY2009.
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According to the the report I found from the OIG (although dated), it states that 30 states report offering some form of Medicaid chiropractic benefit under a fee for service arrangement.
To see if your state allows any benefits go to: http://oig.hhs.gov/oei/reports/oei-06-97-00480.pdf
It also lists guidelines and restrictions for each state.
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Thanks for that info!
Michele
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Yup, NY will not cover chiropractic at all. Not even Acupuncture. I get a lot of inquiries from chiropractors on that. I don't like billing or working for chiro's at all anyway! :o
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Not for maxed benefits. If it is a non covered service, you have to let them know before the appointment that it is non covered and give them the option to not receive service. If it is a covered service and they max their benefits, you need to contact medicaid to see if the will authorize additional services before the appointment. You can not, however, bill the patient for a covered maxed benefit. That is how it is here in Indiana.