j.berkshire
Guest
I've searched this forum, followed links and re-read the IOM-04 and cannot determine if the amount to be billed to a patient undergoing a preventive service which includes a problem-oriented service is the preventive charge - problem oriented charge or the preventive charge - problem oriented allowed amount.
From the IOM: "The physician may charge the beneficiary, as a charge for the noncovered remainder of the service, the amount by which the physician's current established charge for the preventive medicine service exceeds his/her current established charge for the covered visit. Pay for the covered visit based on the lesser of the fee schedule amount or the physician's actual charge for the visit."
From the IOM: "The physician may charge the beneficiary, as a charge for the noncovered remainder of the service, the amount by which the physician's current established charge for the preventive medicine service exceeds his/her current established charge for the covered visit. Pay for the covered visit based on the lesser of the fee schedule amount or the physician's actual charge for the visit."