Date: 11/04/2002
Q:
If a provider uses two separate fee schedules, one for Medicare and one for the rest of his business,
could he be liable for discrimination?
A:
Assuming the Medicare fee schedule is the lower of the two,
there is no discrimination from a regulatory standpoint. In fact, you should not charge a Non Medicare patient
a fee lower than the fee you accept from Medicare.
From an operational standpoint, we do not recommend the use of two fee schedules unless you are a
non-participating provider with Medicare and you are required to bill your limiting charge.
(See our response to the Topic, Medicare Reimbursement) Otherwise, the use of a single fee schedule
is recommended.
Russell Still (bio...)
Executive Vice President
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