Article Detail - JE Part B
Medicare Physician Fee Schedule Reductions - Appeals Newsletter Part 4
Did you know certain provider types are not reimbursed the full Fee Schedule payment amount?
Provider types subject to reduced fees:
- Nurse Practitioner - 85 percent
- Clinical Nurse Specialist - 85 percent
- Physician Assistant - 85 percent
- Licensed Clinical Social Worker - 75 percent
- Non-participating providers - 5 percent reduction
You will want to make sure you know the correct amount for your reimbursement, so you do not submit unnecessary appeals.
Source; CMS Publication 100-04 Chapter 12 - Medicare Claims Processing Manual
Last Updated Apr 18 , 2023
