Newsletter

Chiropractic Medicare Fee Schedule

Updated: January 11, 2011
Dear Doctors and Staff,

WPS, along with other Medicare carriers, have finished testing and have posted the fees for 2011. Due to the Relative Value, fees decreased a few pennies.
Example: IL Local 99 98940 Limiting charge $26.76
IL Local 99 98941 Limiting charge 37.36
IL Local 99 98942 Limiting charge 48.10
Each doctor in the country must go to your specific carrier web site, go to Physician Fee Schedule for 2011, check the fee schedule for your state and local and review the fees for 98940, 98941 and 98942.

At the present time, the Medicare carriers are doing their best to do audits, reviews, etc., to stop paying for what they call "NON Covered Services"or "Maintenance Care". That is really Chiropractic adjustments the Chiropractor failed to document the necessity for payment. The real problem is that the Medicare carriers do not have the ability and finances to review each claim as they receive it. So they do post-payment review audits to try to recoup money.

As we go into paperless claims and paperless documentation, this problem of NOT reviewing claims as received ends. Soon, when you file a claim to Medicare that you have not sufficiently documented, it will be denied immediately. The good news, post payment review will end. However, every doctor and staff must know the correct way to document by federal standards or you will not get paid!

Presently, many doctors and staff are billing Medicare and NOT documenting correctly! Since Medicare pays all "clean" claims, doctors are getting paid and only a small percent the post payment audits. This will all change beginning this year. We must know how to document correctly in Medicare.
BOTTOM LINE: If you wish to learn how to do Chiropractic Medicare correctly, including "documenting" by federal standards, please consider ordering our Chiropractic Medicare DVD and booklet. It explains piece by piece every important step in doing and billing Chiropractic Medicare so there are no limits for the chiropractic adjustment. If you are audited you will have done Medicare correctly and win your audit. You and your staff will be very happy you have this important and mandatory information. I promise it will make a difference in your understanding of Medicare and how you bill Medicare.
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Keep in mind, Medicare is the only insurance type program that if done incorrectly is fraud, a felony, a fine and/or jail.

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I promise you will be more than satisfied that you made the right decision to purchase this information or attend our presentation. Please give me a call if you have questions. 1-618-395-3162

Best regards,
Dr. Gary R. Street


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