For example, can you charge one patient $100 for 99213 and another patient $130 for the same CPT code, 99213? I know it's not practical but would it be legal?
From what I've read "Medicare and commercial payers may view the routine waiver of copays as a misstatement of the physician's actual charge, resulting in false claims liability."
I know waiving copays is not exactly the same as having 2 different charges. If the allowed amount for 99213 is $80 and you write off $20 for the first patient and $50 for the second patient you are charging both patients the same amount in the end and would not be in violation of your contract with the payer.
I guess I'm confused by the language of the "physician's actual charge."
From what I've read "Medicare and commercial payers may view the routine waiver of copays as a misstatement of the physician's actual charge, resulting in false claims liability."
I know waiving copays is not exactly the same as having 2 different charges. If the allowed amount for 99213 is $80 and you write off $20 for the first patient and $50 for the second patient you are charging both patients the same amount in the end and would not be in violation of your contract with the payer.
I guess I'm confused by the language of the "physician's actual charge."
