Physicians Practice - July/August 2008 - (Page 64)

v76.2 or v76.47. The procedure is billed with HCPCS codes, described in the chart below. Usually, other payers do consider the Pap to be part of a preventive exam — and so also part of the E&M code. There are some payers in the country that have determined they will pay separately for the collection of the Pap smear when performed at the time of a routine preventive exam. Usually they provide written instructions to bill the Q0091 as an additional code. If the payer has issued that instruction, report the code. charged a fee equal to the Medicare allowable or up to the limiting charge (115 percent) of the Medicare allowable depending on practice. A There is no legal reason not to charge Medicare/Medicaid more than they pay. It is your usual and customary charge. Furthermore, you run the risk of commercial payers insisting that what you charge Medicare/Medicaid is your usual and customary charge, and they’ll happily pay you the same. Plus, you run the risk of making mistakes and charging wrong. HCPCS CODES G0101 G0123, G0143-G0145, G0147-G0148, P3000 G0124, G0141, P3001 Q0091 HCPCS CODE DESCRIPTORS Cervical or vaginal cancer screening; pelvic and clinical breast examination Screening cytopathology (see current HCPCS book for additional descriptors) Physician’s Interpretation of Screening Pap Tests Screening Pap smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory SETTING MARKETING BUDGET Q I am looking for benchmarks for marketing budgets for physician practices. A The benchmarks are included in the Medical Group Management Association’s Cost Survey. For multispecialty practices — not hospital owned — the median is 0.39 percent of total medical revenue, or $2,927 per FTE physician. UNIQUE FEE SCHEDULE FOR MEDICARE/MEDICAID And, your gross collection rate will be whacked out. Why try to solve a problem that does not exist? There are enough problems that do exist. RELOCATING AN OFFICE Q I have been unable to find any tips for managing the relocation of a medical office. We will be moving in six months and this would be most helpful. A Much depends on exactly what kind of a switch you are making, but consider these issues: • Incorporation — Are you just mov- Q Is it legal for a practice to charge Medicare/Medicaid according to one fee schedule and to charge commercial carriers at another fee schedule? My office would have two fee schedules. The reason is that the allowable from CMS and some of the commercials are so varied, especially for surgery, that the practice is concerned that Medicare/Medicaid may see it as overcharging CMS. I am aware the OIG is unsuccessfully pushing for Medicare charges to exceed no more than 120 percent of the allowable amount. In this scenario self-pay patients would be 64 | PHYSICIANS PRACTICE | JULY/AUGUST 2008 ing, or are you setting up a new practice? Most states will let you practice as a “foreign” corporation when you relocate to a new state, but there may be more hassle. If so, you’d be better off liquidating the old corporation and incorporating again in your new community. • Finding and ﬁling paperwork with all payers, vendors, etc. — Assuming you have an address picked out, ﬁll out the paperwork to change your WWW.PHYSICIANSPRACTICE.COM http://DoctorDirectory.com http://www.ddsignup.com http://DoctorDirectory.com http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - July/August 2008

Physicians Practice - July/August 2008 Contents The Bigger Picture: Battle Royale in the EMR Market Letters Physicians Practice Pearls: Hire Right Noteworthy Cover Story: Healthcare Reform: Voting for Change Patient Relations: Dealing with Problem Patients The tech Doctor: Is Self-Service Medicine Inevitable? Technology: Do EMRs Make You a Better Doctor? The Guide Idealab: Cash-Only Care Still Works The Administrators Desk: Who’s in Charge? Ask The Experts What Went Wrong: ‘Why Our Great Idea Didn’t Work’ Coding Start It Up: How to Launch a Practice: Operations Partnership: Don't Let Partner Conflict Destroy Your Practice Appraisals: What’s Your Practice Worth? Getting Advice: How to Hire a Consultant Classifieds Advertiser Index

Physicians Practice - July/August 2008

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