Wiki Incarcerated patient

[tilquist3@comcast.net]

If a patient is incarcerated, has Medicare and Medicaid, we are billing Medicare with QJ modifier, is that okay for State of IL or should we bill Medicaid as primary in this case?

 

[mnmd9488]

I'm not sure about your state's policy , but here in CA if pt is incarcerated there is inmate "insurance" for each facility that we bill not Medicare or Medicaid. Hope this helps!

Also, here is a link to CMS that might be helpful to you.

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Items-Services-Furnished-to-Beneficiaries-in-Custody-Under-Penal-Authority-Fact-Sheet-ICN908084.pdf#:~:text=42%20CFR%20411.4%28b%29%2C%20Medicare%20payments%20for%20items%20and,by%20reason%20of%20insanity%29%2C%20whether%20insured%20or%20uninsured.

 

[tilquist3@comcast.net]

I'm not sure about your state's policy , but here in CA if pt is incarcerated there is inmate "insurance" for each facility that we bill not Medicare or Medicaid. Hope this helps!

Also, here is a link to CMS that might be helpful to you.

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Items-Services-Furnished-to-Beneficiaries-in-Custody-Under-Penal-Authority-Fact-Sheet-ICN908084.pdf#:~:text=42%20CFR%20411.4%28b%29%2C%20Medicare%20payments%20for%20items%20and,by%20reason%20of%20insanity%29%2C%20whether%20insured%20or%20uninsured.

Thank you.