Frequently Asked Questions (FAQs)
Categories for FAQs:
Vision Therapy/Vision Rehabilitation
Q: I have an adult 79 year old patient with intermittent esotropia and high esophoria. It is progressing which has a negative effect on his work and hobbies. I can do vision therapy to help him. He has Medicare and my office is not participating in Medicare. How can I bill it and be reimbursed properly?
A: Because this is a Medicare patient and you're doing your best to gain some portion of reimbursement for the patient, and because the office is not a Medicare provider, you should not charge more than Medicare's limiting charge for any covered services. The limiting charge is 109% of Medicare's allowed amount in each case. Technically you may bill the patient anything you want, but woe befalls the one who actually collects more than the limiting charge for any covered services. Bill the patient for the office visits and therapy and submit the claim to Medicare, indicating whether or not you will accept assignment.