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Who get's the copay??

  1. Question Who get's the copay??
    Medical Coding Books
    For Medicare Advantage plans:
    If a facility bills revenue code 510 (for use of the room) and a provider bills 99213 (for his services) which claim takes the copay?

  2. #2
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    Sioux Falls South Dakota
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    Quote Originally Posted by AlanaStewart View Post
    For Medicare Advantage plans:
    If a facility bills revenue code 510 (for use of the room) and a provider bills 99213 (for his services) which claim takes the copay?
    It really depends on which Medicare Advantage plan they have. We found, when we went provider based, that the majority were applying two copays - one for the facility and one for the physician. The best thing is to check with the carrier. And do let the patients know if they are going to be charged for two separate copays - it saves angry phone calls.

    Hope this helps.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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