Re: Reimbursement question

[Guest guest]

B Schroedter,

" Is it logical to deduce, then, that the maximum Medicare (or any

insurer) will pay is $30.38 x 4 = $121.52 per patient? "

YES

And If your Billed Charge is $50.00 for 97535 code and you reported 4

units on the claim, your total billed charge should be $200.00

" I realize this doesn't apply to eval or re-eval "

Because Evaluation and Re-evaluation Codes are untimed codes. In my

opinion, they are always reported as 1 unit on the claim.

Wivine

Biller

www.wmedclaimsbilling.com

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>

> If Medicare typically pays better than a private insurer, and the

Medicare payment for a Non-

> facility billing 4 units per hour that only uses treatment codes

97110, 97112, 97140, 97530,

> 97535, which max out at $30.38 per unit for FL/Miami region (for

97535), is it logical to

> deduce, then, that the maximum Medicare (or any insurer) will pay

is $30.38 x 4 = $121.52

> per patient? I realize this doesn't apply to eval or re-eval.

>

> Thanks,

> B Schroedter, PT

> Miami, FL

>