I am trying to locate Medicare's regulation regarding charges. It has always been my understanding that a physician and/or facility must be consistent with their charges. By this I mean, you are not permitted to charge a Medicare recipient differently than a Commercial Insurance recipient or a self pay; the fee schedule should be the same across the board.
Example: code 99241 Medicare is being billed $175.00
code 99241 Aetna is being billed $150.00
code 99241 Self-pay is being billed $150.00
I certainly understand the reimbursement will be different and that we can charge any amount we want, but that gross charge should be the same for everyone.
Any help finding this regulation is much appreciated.
R Kennedy, CPC
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