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Next Reply: Re:10% primary care bonus
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Post 10% primary care bonus
Author: charliej
Date: Jun 8, 2012 11:14 am
This is more a question for aahpm however they have not answered me. I am a medical director of a hospice. one of our contracted physicians says that he is entitled to the 10% primary care bonus for seeing our hospice patients according to cms. the problem is we cannot find anything from cms that verifies this. we bill cms under our NPI number not his. these are hospice related services. we reimburse him 100% of allowable charges. my understanding is that as a hospice contraced physician he cannot bill medicare part B for hospice related services. if he saw a patient for a non hospice related service then he could bill medicare part b(using his NPI) and would be allowed the 10 % bonus payment, but he would only get 80% of what was billed and would have to get the rest from the patient. Because we are billing under our NPI he does not get a 10 % bonus, am i correct? this problem and question must be coming up elsewhere, any comments, suggestions?
dr charles mccammon
chief medical director
vna-ic hospice
Replies: order by [Date] [Author] [Subject]
Re:10% primary care bonus (by JulieP on 06/13/2012)
You are correct that as a hospice contracted provider that the physician you mention cannot bill Part B, so that alone means he doesn't qualify for the 10% primary care bonus. I think you are correct on all your other points as well. I'll do a little research to see what I can find and get back to you if I find anything uselful.
Julie Pipke, CPC
CAPC Consultant
Re:10% primary care bonus (by gcooneymd on 06/22/2012)
I apologize - AAHPM sent me your question but I've been traveling and it fell through the cracks. The 10% primary care bonus is a Medicare Part B bonus. As all physician billing for hospice patients is made under Medicare A, the bonus does not apply.

You are correct that, as a hospice contracted physician, he cannot bill Medicare B for care related to the hospice diagnosis.
Re:10% primary care bonus (by gcooneymd on 06/22/2012)
I apologize - AAHPM sent me your question but I've been traveling and it fell through the cracks. The 10% primary care bonus is a Medicare Part B bonus. As all physician billing for hospice patients is made under Medicare A, the bonus does not apply.

You are correct that, as a hospice contracted physician, he cannot bill Medicare B for care related to the hospice diagnosis.

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