You can bill the G0101, the Q0091 and an E/M service 99201-99215 with a 25modifier to Medicare when performing the pap, pelvic and breast exams on a Medicare patient who has a problem when your physician documents correctly. You can bill Medicare for the G0101 and the Q0091 for the pap/pelvic and breast exams and bill the patient a carved out rate (Your charge for a preventative exam minus Medicare's allowed amounts for the G0101 and Q0091 codes) for the preventative portion of the "well woman" exam. If you are going to bill the patient I would inform them of this ahead of time as you do not want upset patients. You do not need an ABN signed for the preventative exam because Medicare never covers the preventative codes. I wouldn't bill the G0101, the Q0091, an E/M and the preventative codes all together.
We do bill our patients for the carved out fee of the preventative exam.
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