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5851Sequestration 2% cut from Commercial Payers?

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  • Melinda
    May 16, 2013

      I rec'd a recent EOB from an insurance company and on a few of my April
      2013 claims (non-Medicare patients) they took the 2% sequestration cut.

      I was under the impression that the 2% sequestration was ONLY applicable
      to Medicare & Advantage Plans.

      I was told by the ins co. provider rep, that since the contract we have
      states that some charges (Drugs: 90715-Tdap, J3301-kenalog,
      J1080-depotestosterone) are based on the Medicare rates (not RVUs) and
      therefore are subject to the 2% cut, even though the patient is NOT a
      Medicare patient.

      I have my provider rep. checking with the contracting dept for

      Is this the same thing everyone has been hearing from other payers?

      Please advise!

      Melinda Brown, CMBS
      Ins Biller
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