Plan N-No $20 Copay on Physical Therapy

Discussion in 'Senior Insurance Forum' started by insurance0707, Sep 24, 2010.

  1. insurance0707
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    insurance0707 Well-Known Member

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    I called both United of Omaha & AARP regarding Plan N and they both told me that physical therapy does not have a $20 copay. It has a different code # when billed. It's not billed as an office call but under physcial therapy. Medicare pays 80% and Plan N will pick up the other 20%
     
  2. DS4
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    DS4 Well-Known Member

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    The office visit co pay applies to "office visits". An office visit consists of, health history, exam and diagnosis.
    A trip to a physical therapist usually only involves "treatment".
    The CPT billing codes will determine if the "office visit" co pay applies.
     
  3. insurance0707
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    insurance0707 Well-Known Member

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    so you're saying possibly that the first visit might have a 20 copay but subsequent visits would not?
     
  4. G.Gordon
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    G.Gordon Well-Known Member

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    What is Luke's view on this matter?
     
  5. DS4
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    DS4 Well-Known Member

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    No.
    RPT does not make a diagnosis. Therefore, CPT codes are all "treatment".
    I really wish Luke would chime in.
     
  6. insurance0707
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    insurance0707 Well-Known Member

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    I was just happy to hear that Physcial Therapy wouldn't be subject to the $20 copays. If a client is going 3 times a week for a couple of months, that could add up. No
    one on this board seemed to know the answer to it....that's why I called AARP and United of Omaha directly
     
  7. DS4
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    DS4 Well-Known Member

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    Your client will also be Happy to pay the $155 Part B deductible.:)
     
  8. luke4275
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    luke4275 Guest

    Considering I didn't know what the part A ded was last week, I go with whatever Rick says
     
  9. insurance0707
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    insurance0707 Well-Known Member

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    They pay the $155 Part B deductible under Plan G also...what's your point

    Do you only sell Plan F?????
     
  10. DS4
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    DS4 Well-Known Member

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    Yes
    By default though. Most of my carriers don't sell D, G or N.
     
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