Loops/Holter Medicare

Casper204

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Somers, CT
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For the longest time, we've split billed Medicare patient's for loops and holters leaving the technical portion to be billed by the company itself. My physicians want to switch to billing Medicare globally because they feel it will raise their reimbursement. My boss is concerned because the reason we've always split billed was based on her interpretation of the anti-mark up policy that Medicare has. She understood it to mean that we can't be reimbursed from Medicare at a higher rate than what we paid for a service. For example, if we paid $150 for a loop but Medicare reimburses $200 for the technical portion, we should still only be billing Medicare for no more than the $150 that we actually paid. For that purpose, it was easier to just split bill and let the company itself deal with billing medicare for the technical portion. My physicians have interpreted the policy as if it's hooked up in the office that the anti-mark up policy doesn't apply.

Does anyone have any information about this? I can't seem to get a straight answer out of anyone that I talk to you. How are you all billing Medicare for these services if you use an outside company to provide the loops and holters? Do you split bill? Bill global? If global, do you adjust your charge to reflect what you pay for the service? Any info is appreciated!
 

bmil

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Waco, TX
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purchased component

This question is old so you must have gotten an answer. In case anyone else has the same question....

It is in the claims manual- under diagnostic testing and under IDTF.
I'm looking for information related to renting the service.
 
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