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Help!!! E/M w/ CPE

Best answers
My question is...If a pt has Medicare primary & a secondary ins can you bill the secondary the full amount of the physical charge when being billed w/ an ov? And if so...if the secondary pays but the pt has a pt balance can it be billed directly to the pt as along as it doesnt exceed the formulated amount by medicare. If anyone has documentation to support this I would greatly appreciate it.