Recently I have received calls and emails from you asking what I know about Medicare recouping money from them because their patient was a QMB.

QMB patients have both Medicare benefits through original Medicare and Medi-Cal (Medicaid if your are not in California).

Medicare provider may not bill beneficiaries enrolled in the QMB program for Medicare Part B deductibles, coinsurance, or co-pays but state Medi-Cal/Medicaid programs may pay those cost.

This applies only to the services that Medicare Part B covers in your office and the only services that are covered are the 98940, 98941 and 98942 codes when medically reasonable and necessary according to Medicare’s guidelines.

Additional information is available in MLN Matters Number SE1128.

Chiropractic Success Systems offers quarterly Medicare webinars and they are approved of for 2.5 hours of distance learning California CEUs for Ethical Coding and Billing.

Leave a Reply

Your email address will not be published.