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Medicare non-par - providers out there

  1. #1
    Default Medicare non-par - providers out there
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    Are there any non- par providers out there? I am now working for my first provider who is Medicare non-par. Does this mean you can bill a Medicare patient for a non-covered service? Thanks in advance!

  2. #2
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    Quote Originally Posted by camilleb View Post
    Are there any non- par providers out there? I am now working for my first provider who is Medicare non-par. Does this mean you can bill a Medicare patient for a non-covered service? Thanks in advance!
    Are you referring to statutorily non-covered items? If so, these are always billable to the patient.

  3. #3
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    Greeley, Colorado
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    We are non-par. You still have to follow CMS guidelines and unless it is denied as "patient responosibility" you cannot bill the patient. If it is a statutorily excluded service as Rebecca points out you can bill the patient whether you are par or non-par.
    Lisa Bledsoe, CPC, CPMA

  4. #4
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    Don't forget the ABN. If you know it is going to be non-covered you will need an ABN signed by the recipient so they know it's non-covered and they are responsible.

  5. #5
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    ABN's are not required for statutorily non-covered services (ie preventive 99397). You can use modifier GY for these services.
    Lisa Bledsoe, CPC, CPMA

  6. #6
    Default Billing Medicare Non-Par
    There are a couple of issues here. First do you have a PTN registered to you by PECOS. If you do not have a PTN you cannot bill Medicare. If you have a PTN you can choose to be Non-Par or Par. This can be an issue. My company does not have a PTN. We are currently going under accreditation and applying for a PTN. We are choosing to remain non-par. Having the PTN allows you to do business with the Federal Government. Depending on your circumstances, your office may choose to be non-par. There are benefits to this. It just depends.

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