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Wiki Out of Network Billing

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Nataliya Fabrje

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Good morning,
My employer is an optometrist who preforms Visual therapy. He is out of network with most insurance carriers. Can we bill CPT code 92066 at full price of $170.00 being out of network. Thank you.
 
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Being out of network means that your provider is not under contract with the insurance companies, therefore has no obligation to charge or accept any particular amount as payment in full for the service. As long as there is no law in the state where your provider practices that regulates what is charged, then your provider may bill whatever amount they choose.
 
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