Wiki Billing Medicare more than the lowest fee

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klobo

Networker
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Poway, CA
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Hello,
I have a client who wants to charge a total of $35 for self-pay patients for the following vaccine:

Pneumovax 90732 - Medicare pays $73.35
Vaccine inj 90471 (G0009 for Medicare) - Medicare pays $24.06

The client wants to bill Medicare $75 for 90732 and $25.00 for 90471 - a total of $100.00

Is it legal to bill Medicare a higher fee than what you offer to your other patients?
Or do we have to bill Medicare the lowest fee offered to the patients?

Any advice on this issue would be appreicated,

Thx a lot,
ken
 
My understanding is everyone must be charged the same amount. Your self pay patients can get a rapid pay discount down to your amount if they pay at time of service. You charge the same amount to everyone but can accept different amounts consistently. Ex..bcbs mcare aid all pay different amounts that you accept.
 
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