When a patient fails to show up for an appointment, the resulting hole in the physician's schedule can mean the loss of billable time. However, a change in Medicare's general billing requirements now allows physicians to charge Medicare beneficiaries for missed appointments.
The policy became effective in October, but many family physicians still are unaware of the change.
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Medicare Billing Change
Physicians Can Charge Patients for Missed Appointments
By News Staff
According to the Medicare Claims Processing Manual, Chapter 1 - General Billing Requirements, (6-page PDF; About PDFs) CMS' new policy allows physicians and suppliers to charge Medicare beneficiaries for missed appointments, as long as they also charge non-Medicare patients for missed appointments.
Calling it "a charge for a missed business opportunity," Medicare says the amount of a missed-appointment charge must be the same for all patients.
Physicians should not submit claims to Medicare for no-show charges because Medicare "does not make any payments for missed appointment fees or charges imposed by physicians," and such charges should not be billed to Medicare. However, according to the Medicare document, Medicare law and regulations "do not preclude the physician or supplier from charging the Medicare patient directly."
Calling it "a charge for a missed business opportunity," Medicare says the amount of a missed-appointment charge must be the same for all patients.
Physicians should not submit claims to Medicare for no-show charges because Medicare "does not make any payments for missed appointment fees or charges imposed by physicians," and such charges should not be billed to Medicare. However, according to the Medicare document, Medicare law and regulations "do not preclude the physician or supplier from charging the Medicare patient directly."
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