Good morning. I'm hoping someone can offer some guidance on this.
The practice I work for is interested in using Aveed for low testosterone. We generally do NOT want to do the buy-and-bill method, but Medicare only allows buy-and-bill. I'm trying to determine if it is financially sensible for us to do this. I spoke with Medicare and they do not have a published fee schedule for the code, which is J3145. I understand that this means the claims would go for pricing and be paid based on that. We don't want to purchase it, administer it, bill the claim, and then find out we have to take a big loss. Has anyone billed Medicare for this and been paid? Were you paid enough that it is financially sensible to buy-and-bill? Our office is located in Kane County, Illinois if anyone local has any information that can help me.
Thanks!
Stephanie Nolte, CUC
The practice I work for is interested in using Aveed for low testosterone. We generally do NOT want to do the buy-and-bill method, but Medicare only allows buy-and-bill. I'm trying to determine if it is financially sensible for us to do this. I spoke with Medicare and they do not have a published fee schedule for the code, which is J3145. I understand that this means the claims would go for pricing and be paid based on that. We don't want to purchase it, administer it, bill the claim, and then find out we have to take a big loss. Has anyone billed Medicare for this and been paid? Were you paid enough that it is financially sensible to buy-and-bill? Our office is located in Kane County, Illinois if anyone local has any information that can help me.
Thanks!
Stephanie Nolte, CUC