Medicare Fees in the Chiropractic Office
How much you should bill to Medicare and how much you should collect from the patient is dependent upon several factors:
- Is the doctor a participator
- Is the doctor a non-participator not accepting assignment
- Is the doctor a non-participator accepting assignment
- What is the Medicare fee schedule for your state and region
- Is Medicare traditional or an advantage plan
- Is Medicare the only insurance
- Is Medicare the secondary insurance
- Does the patient have Medicare and Medicaid and if so are they in the QMB program
- Is the patient working in a company that has over a certain number employees
- Does the patient have Medicare but spouse is covered under their employer
- Has the patient been in a motor vehicle accident
- Did the patient sign an ABN
- What if the patient has Part A only
- Is the doctor following the Physician Quality Reporting System
- Is the doctor using electronic health records (EHR)
- Is the patient’s care active/corrective or maintenance
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