ED Coding & Reimbursement Alert - 2008 Issue 9
READER QUESTION: CMS Says No-Show Fee Is OK - Sometimes
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Article Overview
This reader Q&A reviews CMS guidance on whether missed-appointment or no-show fees may be charged in Medicare contexts. It is aimed at providers, billing staff, and compliance teams who need a high-level understanding of the policy, related payer considerations, and the circumstances discussed by CMS in an MLN Matters update.
Why This Topic Matters
Missed-appointment fee policies can affect compliance, patient billing practices, and how providers handle Medicare and non-Medicare patients consistently. The article helps readers understand the general CMS position and the practical billing caution it raises.
What You Will Learn
- The CMS position on charging fees for missed appointments in Medicare-related situations.
- Why consistency across Medicare and non-Medicare patients matters for no-show fee policies.
- The distinction between billing the patient directly and billing Medicare for a missed appointment.
- General hospital outpatient considerations discussed in CMS guidance.
- The relevance of the policy implementation date and payer verification.
Who Should Read This
- Physicians and group practices
- Hospitals and hospital outpatient departments
- Medical billing staff
- Coding and compliance professionals
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
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