tci Part B Insider - 2011 Issue 40

Reader Question: ABN Not Required for These Psychiatric Visits

Question: We know that "PR-122" is a "Psychiatric reduction in payment" code for Medicare carriers. I have always billed the patient for this share of the payment not made. However, my co-worker recently asked me if I need an ABN in order to bill the patient. I don't think we do, but could really use another opinion here. Can you advise?Submitted to coding911.comAnswer: Medicare pays 50 percent of most outpatient psychiatric services, and the balance is the patient's responsibility. "If it is a non-covered benefit, an ABN (advance beneficiary notice) is not required, but an ABN can...

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