decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Medicare_Carriers_Manual / 15036 / 15036
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Article Overview
This article covers Medicare payment policy for site-of-service differentials under the physician fee schedule. It is relevant to coders, billing staff, and reimbursement professionals who need to understand how setting of service affects payment inputs across hospitals, skilled nursing facilities, ambulatory surgical centers, and other locations. The discussion focuses on general Medicare guidance and place-of-service concepts rather than code-by-code reporting instructions.
Why This Topic Matters
Understanding site-of-service payment methodology is important for accurate reimbursement and for recognizing when setting-related payment inputs differ across facilities and non-facility environments. This section helps readers interpret Medicare policy affecting physician fee schedule payment calculations.
Article Sections
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15036. Site-of-Service Payment Differential
This section describes Medicare physician fee schedule payment treatment by site of service. It discusses facility and non-facility payment inputs across several care settings and identifies the broad circumstances in which each applies.
What You Will Learn
- How Medicare distinguishes between facility and non-facility payment inputs
- Which broad care settings are addressed in the policy discussion
- How site of service can affect physician fee schedule payment methodology
- How therapy procedures are treated in the context of site-of-service payment policy
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle professionals
- Physician practice managers
- Compliance staff
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