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Thread: Cosmetic vs Insurance Billing

  1. #1

    Default Cosmetic vs Insurance Billing

    AAPC: Back to School
    My doctor has in his mind that we can have two different price lists, one for cosmetic surgery and one for insurance billing. I know this is isn't true but I need something in writing to show him. HELP!!!

  2. #2


    In Texas, for example, it is illegal to have more than one fee schedule (exepting Medicare & Medicaid), but I am not aware of other states that prohibit multiple fee schedules.

    In the example you give -- insurance v. cosmetic -- would it also be true to label it insurance v. no insurance? If so, then wouldn't you agree that many providers have fees for those with and those without insurance?

    Sounds like the same thing to me. Doctors have been using multiple fee schedules for years. Unless I see something in writing like the TX statute, I believe it is okay and in some cases, important - you don't want to charge everyone your Medicare rates, right?
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    AMBACode Coding Software
    2015 AMBA National Medical Billing Conference

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