Forum - Questions & Answers
Can you charge insurance payers different fees for the same CPT®?
What is the policy on practices charging different fees for the same CPT® when billing different payers. Under the payer contracts, the patient cannot be charged more than the contracted amount, but, is a practice OK to charge say, Medicare $170.00 for a 99213 and charge UHC $270. for a 99213? Can't find any information. Thanks! Carole
re: Can you charge insurance payers different fees for the same CPT®?
why would you want to? payers will only pay what they allow anyway.
re: Can you charge insurance payers different fees for the same CPT®?
Is there a policy or guideline answer to this question (Codepedia Editor?). This may sound like a silly question, but I need something to present to management that will speak to policy on establishing fees and to skewing CMS RVUs by inflating charges, etc. Anyone with a business-related answer? Thank You, Carole