Wiki Billing Medicare Patients at a freestanding facility

Cavalier40

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Stuart, FL Sailfish Chapter
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Mental Health and Substance Abuse services are not covered under Medicare when performed at a non hospital freestanding facility. So the question is how do we approach billing Medicare patients?

In the past we were able to send a letter to Medicare saying we could not bill for services and get a letter from CMS that can work as a medicare denial so we can bill the secondary. However this is a time consuming process and we have to wait 30-45 days before we can even submit the claim.

Since we do not submit to Medicare, would billing Medicare with a GY modifier even be possible?

What would be the most efficient way to get a denial so that we can bill the secondary?
 
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