# Medicare non-par - providers out there



## camilleb (Mar 31, 2010)

Are there any non- par providers out there?  I am now working for my first provider who is Medicare non-par.  Does this mean you can bill a Medicare patient for a non-covered service?  Thanks in advance!


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## RebeccaWoodward* (Apr 1, 2010)

camilleb said:


> Are there any non- par providers out there?  I am now working for my first provider who is Medicare non-par.  Does this mean you can bill a Medicare patient for a non-covered service?  Thanks in advance!



Are you referring to *statutorily* non-covered items?  If so, these are always billable to the patient.


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## Lisa Bledsoe (Apr 1, 2010)

We are non-par.  You still have to follow CMS guidelines and unless it is denied as "patient responosibility" you cannot bill the patient.  If it is a statutorily excluded service as Rebecca points out you can bill the patient whether you are par or non-par.


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## Jenny8675309 (Apr 2, 2010)

Don't forget the ABN. If you know it is going to be non-covered you will need an ABN signed by the recipient so they know it's non-covered and they are responsible.


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## Lisa Bledsoe (Apr 2, 2010)

ABN's are not required for statutorily non-covered services (ie preventive 99397).  You can use modifier GY for these services.


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## pskibbe (Jun 8, 2010)

*Billing Medicare Non-Par*

There are a couple of issues here.  First do you have a PTN registered to you by PECOS.  If you do not have a PTN you cannot bill Medicare.  If you have a PTN you can choose to be Non-Par or Par.  This can be an issue.  My company does not have a PTN.  We are currently going under accreditation and applying for a PTN.  We are choosing to remain non-par.  Having the PTN allows you to do business with the Federal Government.  Depending on your circumstances, your office may choose to be non-par.  There are benefits to this.  It just depends.


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