Part B IP physician bill after Part A days exhausted

vcar

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Hi all.

Does anyone know if Medicare Part B will pay on daily physician hospital visits (99231-99233) rendered after the patient has exhausted their Part A benefits for that stay? We've never run into this before. Any input would be great.

Thanks.
 

vcar

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No, all physician services are a Part B benefit, they're never covered by Part A.
I guess I didn't phrase my question clearly so here's the scenario. Patient has Medicare A&B. Is an IP and has exhausted all their Part A days including their lifetime reserve days as of 4/10/16. I am billing for the Part B E/M physician charges. I've been told that since the part A days exhausted on 4/10/16, Part B will also deny all services rendered after 4/10/16. Does anyone know if this is true?

Thanks.
 

CodingKing

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Not the best source since its not directly from CMS but according to this AARP Q&A article part B will still cover part B services while inpatient even if your benefits are exhausted for the Part A services

http://www.aarp.org/health/medicare-insurance/info-02-2009/ask_ms__medicare_17.html

This is from the section about reserve days:

Once the 60 reserve days are exhausted, you would pay the hospital’s full daily charge (except for services covered under Medicare Part B, such as physician visits) if you need to stay in the hospital for more than 90 days in a benefit period.
 
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thomas7331

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Sorry did not quite understand your original question. I believe that's correct - If the patient has Part B coverage, then there isn't a limitation on the physician service coverage just because the Part A days have been exhausted.
 

vcar

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Thanks all.

I too always thought that even if Part A days had been exhausted Part B would still pay the doc for their services. So I thought I'd reach out.

Thanks again!
 
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