Re: Billing patients for supplies

[Guest guest]

Hi Dirk,

You cannot issue and bill any DME through Medicare unless you are a

licensed and Medicare contracted DME dealer as well. This usually applies

to Medicaid as well (definitely in Idaho). So with Medicare patients, CMS

assumes that the cost of equipment, like wound care supplies or theraband

is included in the payment for the treatment.

Many clinics will explain this to their patient and have them purchase the

equipment from a DME supplier (like wound care supplies, compression

stockings etc)for those supplies that will end up costing a fair amount.

For smaller items like a length of theraband or electrodes, clinics will

give it out and assume the cost as bundled in the Medicare payment.

Novel ideas are to create a loaner system (including Theraband which can

be cleaned and sterilized). Those that recover may be willing to donate

things back. This is not recommended with electrodes or things that

cannot be cleaned but it is an option for a practice and helps hold down

costs.

For private insurances, you would have to check the contract. Some will

allow you to bill for supplies and some not. Some will allow certain

supplies and some not. Best to have your billing person or agency call

and create a list by insurance of what is billable and what is not. Work

comp and third party insurances usually do allow you to bill the equipment

but again you would need to check to be sure. Be careful that you have

one set price list for this equipment as it is not advisable to charge

differently for each insurance.

When issuing DME, it is recommended that you alert the patient/client

first of cost, why there is a mark up (convenience mainly), whether it is

covered or out of pocket and the use. When I had my clinic, we were

moving to a written DME form, similar to the Medicare ABN in which the

person could accept or refuse. Seems like a lot of work but it saves on

the number of phone calls to billing to complain aobut a bill for DME that

the patient did not know they would receive.

How that helps!

M Howell, PT, MPT

IPTA Payment Specialist

Meridian, ID

thowell@... >

Group,

>

> Is anyone billing patients for supplies such as T-band, electrodes,

> tape, etc. in an outpatient setting? Can you do this for Medicare

> patients?

>

> Thanks

>

>

> Dirk Baird, DPT

[Guest guest]

Those items, except for electrodes, are not reimbursed by the Medicare program

and are statutorily non-covered by the Medicare program. Because of that, you

can bill the Medicare patient for supplies that the patient purchases to use at

home and no ABN form is required. This could include thera-band, swiss balls,

tape, bio freeze, etc.

Regarding electrodes, the cost of electrodes is included in the reimbursement

you receive for unattended e-stim and iontophoresis and you can't bill the

Medicare patient for the electrodes.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc.

www.gawendaseminars.com

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& Consulting, Inc. on Twitter

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Subject: Billing patients for supplies

To: PTManager

Date: Monday, May 21, 2012, 9:02 PM

 

Group,

Is anyone billing patients for supplies such as T-band, electrodes, tape, etc.

in an outpatient setting? Can you do this for Medicare patients?

Thanks

Dirk Baird, DPT