Practice Management Alert
Reserve IPPE Billing for First 12 Months
Question: A Medicare patient came to our office for his IPPE exam. However, hes been enrolled in the Medicare program for 14 months. Can we still bill Medicare for performing the IPPE? Washington D.C. Subscriber Answer: No. CMS clarified the answer to this very question in an April 7 Open Door Forum (ODF). During that call, CMS officials stated that you can only bill and collect for initial preventive physical exams (IPPEs) that your physician conducts within the first 12 months of the beneficiarys Medicare eligibility period. Medicare will deny claims for any IPPEs that your physician performs outside of that 12-month window. Good practice: If you have any doubt regarding whether a patient qualifies for IPPE reimbursement, you should contact your contractor before conducting the IPPE to confirm the patients eligibility, CMS officials suggested. Tip: Some of the insurance eligibility systems available will indicate how long a patient has been eligible so that you can confirm their eligibility for the IPPE online.
Practice Management Alert
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