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Re: Medicare Psychiatric Reduction

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  • Melinda
    If you see on your Medicare EOB, it puts the psych reduction to PR122, which can be billed to the patient (PR=Pt resp). We bill it to the secondary insurance.
    Message 1 of 4 , Sep 6 10:30 AM
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      If you see on your Medicare EOB, it puts the psych reduction to PR122, which can be billed to the patient (PR=Pt resp). We bill it to the secondary insurance.

      Melinda Brown, CMBS
      Ins Biller

      --- In MedicalBillers@yahoogroups.com, DTru <dtru@...> wrote:
      >
      > For Mental Health billers:
      >
      > I have just discovered the 20% Psychiatric Reduction from Medicare
      > for an office in Kansas. Arizona does not have such a reduction! I
      > do not understand why Medicare, a Federal Program, reduces their
      > payment schedule in one part of the country and not in another. I am
      > also amazed that they are doing this with claims with DXs between 290
      > and 319. That pretty much covers all mental disorders.
      > How do you, the practitioners on this list, handle such a thing? Do
      > you find other DX codes or procedure codes that are still
      > appropriate to the situation, or do you just "take it on the chin"?
      >
      > One doctor tells me that she will discuss meds with the patient and
      > then bill the code 90862.
      >
      > I also see that the reduction will be phased out by 2014.
      >
      > Frankly, I think this is one of the craziest things I have heard from
      > Medicare, and that is saying a lot!
      >
      > Any input will be Greatly appreciated!
      >
      > Many Thanks,
      >
      > Deb
      >
      >
      > Tru Medical Billing,
      > at your service
      >
      > Deb Tru
      > 602-525-9888
      > Fx: 866-582-6936
      > www.tmedbilling.com
      >
      > [Non-text portions of this message have been removed]
      >
    • DTru
      Thanks Melinda, I guess the patient with no secondary gets to pay the difference. ... Many Thanks, Deb Tru Medical Billing, at your service Deb Tru
      Message 2 of 4 , Sep 13 4:15 PM
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        Thanks Melinda, I guess the patient with no
        secondary gets to pay the difference.


        At 10:30 AM 9/6/2012, you wrote:
        >
        >
        >If you see on your Medicare EOB, it puts the
        >psych reduction to PR122, which can be billed to
        >the patient (PR=Pt resp). We bill it to the secondary insurance.
        >
        >Melinda Brown, CMBS
        >Ins Biller
        >
        >--- In
        ><mailto:MedicalBillers%40yahoogroups.com>MedicalBillers@yahoogroups.com,
        >DTru <dtru@...> wrote:
        > >
        > > For Mental Health billers:
        > >
        > > I have just discovered the 20% Psychiatric Reduction from Medicare
        > > for an office in Kansas. Arizona does not have such a reduction! I
        > > do not understand why Medicare, a Federal Program, reduces their
        > > payment schedule in one part of the country and not in another. I am
        > > also amazed that they are doing this with claims with DXs between 290
        > > and 319. That pretty much covers all mental disorders.
        > > How do you, the practitioners on this list, handle such a thing? Do
        > > you find other DX codes or procedure codes that are still
        > > appropriate to the situation, or do you just "take it on the chin"?
        > >
        > > One doctor tells me that she will discuss meds with the patient and
        > > then bill the code 90862.
        > >
        > > I also see that the reduction will be phased out by 2014.
        > >
        > > Frankly, I think this is one of the craziest things I have heard from
        > > Medicare, and that is saying a lot!
        > >
        > > Any input will be Greatly appreciated!
        > >
        > > Many Thanks,
        > >
        > > Deb
        > >
        > >
        > > Tru Medical Billing,
        > > at your service
        > >
        > > Deb Tru
        > > 602-525-9888
        > > Fx: 866-582-6936
        > > www.tmedbilling.com
        > >
        > > [Non-text portions of this message have been removed]
        > >
        >
        >



        Many Thanks,

        Deb


        Tru Medical Billing,
        at your service

        Deb Tru
        602-525-9888
        Fx: 866-582-6936
        www.tmedbilling.com

        [Non-text portions of this message have been removed]
      • Melinda
        Correct.
        Message 3 of 4 , Sep 14 11:42 AM
        • 0 Attachment
          Correct.

          --- In MedicalBillers@yahoogroups.com, DTru <dtru@...> wrote:
          >
          > Thanks Melinda, I guess the patient with no
          > secondary gets to pay the difference.
          >
          >
          > At 10:30 AM 9/6/2012, you wrote:
          > >
          > >
          > >If you see on your Medicare EOB, it puts the
          > >psych reduction to PR122, which can be billed to
          > >the patient (PR=Pt resp). We bill it to the secondary insurance.
          > >
          > >Melinda Brown, CMBS
          > >Ins Biller
          > >
          > >--- In
          > ><mailto:MedicalBillers%40yahoogroups.com>MedicalBillers@yahoogroups.com,
          > >DTru <dtru@> wrote:
          > > >
          > > > For Mental Health billers:
          > > >
          > > > I have just discovered the 20% Psychiatric Reduction from Medicare
          > > > for an office in Kansas. Arizona does not have such a reduction! I
          > > > do not understand why Medicare, a Federal Program, reduces their
          > > > payment schedule in one part of the country and not in another. I am
          > > > also amazed that they are doing this with claims with DXs between 290
          > > > and 319. That pretty much covers all mental disorders.
          > > > How do you, the practitioners on this list, handle such a thing? Do
          > > > you find other DX codes or procedure codes that are still
          > > > appropriate to the situation, or do you just "take it on the chin"?
          > > >
          > > > One doctor tells me that she will discuss meds with the patient and
          > > > then bill the code 90862.
          > > >
          > > > I also see that the reduction will be phased out by 2014.
          > > >
          > > > Frankly, I think this is one of the craziest things I have heard from
          > > > Medicare, and that is saying a lot!
          > > >
          > > > Any input will be Greatly appreciated!
          > > >
          > > > Many Thanks,
          > > >
          > > > Deb
          > > >
          > > >
          > > > Tru Medical Billing,
          > > > at your service
          > > >
          > > > Deb Tru
          > > > 602-525-9888
          > > > Fx: 866-582-6936
          > > > www.tmedbilling.com
          > > >
          > > > [Non-text portions of this message have been removed]
          > > >
          > >
          > >
          >
          >
          >
          > Many Thanks,
          >
          > Deb
          >
          >
          > Tru Medical Billing,
          > at your service
          >
          > Deb Tru
          > 602-525-9888
          > Fx: 866-582-6936
          > www.tmedbilling.com
          >
          > [Non-text portions of this message have been removed]
          >
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