FEB 02, 2023
Separate Fee Schedule for Self-Pay Patients
Question: May a practice have separate fee schedules for commercial insurance vs. self-pay price?
Answer: Advice from
Fundamentals of Ophthalmic Coding:
Physicians may choose to have numerous fee schedules. The rule to follow is that the practice cannot charge Medicare patients more than the practice’s usual and customary charge. Or simply stated, you cannot charge Medicare Part B beneficiaries a higher amount than others, including self-pay.