Plan N for physical/occupational therapy, office visit or not

[yorkriver1]

In my experience so far, with a family member, physical therapy and cardiac rehab were not billed as office visits, therefore not subject to the $20 max payment for office visits.
Your claims experience related by clients or directly?
Needing to not make statements of absolutes here. Potentially no charge after Part B deductible is met, depending on billing. Just haven't heard so far of clients getting charged for these services after Part B Deductible on Plan N.

 

[Chazm]

I’ve seen it billed both ways and I explain it to my Plan N prospects that it shouldn’t be a copay. But, if they bill it as an office visit, it’s tough to change it.

 

[Special Agent]

In my experience so far, with a family member, physical therapy and cardiac rehab were not billed as office visits, therefore not subject to the $20 max payment for office visits.
Your claims experience related by clients or directly?
Needing to not make statements of absolutes here. Potentially no charge after Part B deductible is met, depending on billing. Just haven't heard so far of clients getting charged for these services after Part B Deductible on Plan N.

it's not suppose to happen but sometimes the PT will add a consultation fee as an Additional Healer Markup to get mo money from the original medicare.You don't see this happen with MA plans though.

 

[vic120]

I’ve seen it billed both ways and I explain it to my Plan N prospects that it shouldn’t be a copay. But, if they bill it as an office visit, it’s tough to change it.

Back when I really started doing more N 2013 to 15 I used to fight it

I found it to be time consuming, I gave up dealing with it, and now I tell people, they are not supposed to charge but they do sometimes

 

[kstein]

I find 1/3 of the time you go to the doctor (for whatever reason) you'll see a copay. No way would I want to be in the weeds on arguing whether it was billed properly as you scale. Way too frustrating