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Medicare pos

Does anyone know if Medicare reimbursement varies depending on place of service? The reason I ask is that I billed several claims for a patient with pos 11 (office), but I found out today that the...

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Re: Medicare pos

Medicare bases reimbursement on the following items:Work expenses, Facilty expenses and Malpractice Rates, plus a factor for the geographical area of the country.

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Re: Medicare pos

Yes, Medicare pays differently depending on the POS for the same service type. For example, we were getting paid less for an outpatient hospital visit than an office visit for the same E/M code. We...

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Re: Medicare pos

I forgot to mention that Medicare does not pay for home care, but I am not sure if that applies to doctor home visits.Sophy @ IDC

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Re: Medicare pos

Wouldn't an outpatient hospital visit CPT code be different than an Office Visit Code?

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Re: Medicare pos

Thanks for your replies,I know that Medicare will pay for occupational therapy performed in a patient's home. I checked the LMRP. I can't find anything about the reimbursement being different for pos...

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Re: Medicare pos

Wouldn't an outpatient hospital visit CPT code be different than an Office Visit Code?Not necessarily. E/M descriptions like 99212 are "office or other outpatient", including outpatient...

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Re: Medicare pos

Last time I checked, pos home was "crosswalked" to pos office.Sharon

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Re: Medicare pos

I would submit a "corrected claim" with a cover letter to your Medicare appeals department. I've done that and gotten the difference in reimbursement with no problem.Sophy @ IDC

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