Assessments for Medicare clients

sadie twite 5 years ago in Payers Module updated by Tracy Filipi 5 years ago 2

Does anyone know if you can do an assessment for a Medicare client and bill for it even if you are not a Medicare contracted provider? We are looking to just do the assessment and then refer to a Medicare contracted facility.

If the assessment is for substance abuse, we don't bill Medicare.  We aren't contracted with Medicare for substance abuse.  Typically Medicare doesn't pay for Rule 25 assessments.

If you are talking about a Diagnostic Assessment, Medicare denied our claims with a CO denial when we used a non certified provider.