"CPT Copyright 2017 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.""

Featured Post

LIST OF MODIFIERS

Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...

Does coinsurance and Deductible applies for Home health services?


According to CMS Transmittals CR 3471 (20.4 - Exceptions to Annual Deductible and Coinsurance) neither the annual deductible
nor the 20 percent coinsurance apply to Parts A and B home health services, except that there is a coinsurance of 20 percent of the payment amount for supplies, drugs, DME and prosthetics /orthotics furnished as a home health benefit.

The annual Deductible and Coinsurance is not appicable for the below services / procedures too

• Clinical diagnostic laboratory tests (including specimen collection fees) performed or supervised by a physician,

laboratory, or other entity paid on an assigned basis;

• Pneumococcal vaccine and its administration;

• Influenza vaccine and its administration; and

• Services or items denied as medically unnecessary.

Reference: https://www.cms.gov/transmittals/Downloads/R11GI.pdf

Also see the complete list of services and procedures for which annual deductibles and coinsurance may apply

Blogger Widget

Popular Posts