Can You Charge a No Show Fee to a Medicare Beneficiary?
Yes, you are allowed to charge a no show fee to a Medicare beneficiary as long as you have an established no show fee policy for all patients at your practice.
“According to Chapter 1, section 30.3.13 of the Medicare Claims Processing Manual – CMS’s policy is to allow physicians and suppliers to charge Medicare beneficiaries for missed appointments, provided that they do not discriminate against Medicare beneficiaries but also charge non-Medicare patients for missed appointments.”
What Qualifies as a Missed Appointment?
CMS Chapter 1, section 30.3.13 does not provide specific guidance in regards to how a missed appointment is defined.
Your practice must have a policy manual and within that policy manual, you must define, in writing, what a “no show” is.
For example, a “no show” may be defined as a non-arrival within 5-minutes of the scheduled appointment time.
Why 5-minutes? Because some practices could have an established policy that states that once a patient is more than 5-minutes late for an appointment that appointment is considered a no-show and the scheduled therapist will perform other activities for the remainder of the appointment time.
Your cancellation policy must also describe the difference between a cancellation that may be rescheduled and a cancellation that is considered a missed appointment.
Many providers have chosen a 24-hour threshold to say that any cancellation occurring with less than 24-hours of notice is considered a missed appointment and subject to the missed appointment policy.
How do you plan to handle weekend cancellations? There will be occasions in which your patient has an appointment scheduled for Monday morning and your 24-hour cancellation policy would require that patient to cancel on or before Sunday morning.
Will your policy allow for voicemail cancellations? If your voicemail system timestamps the day and time a message is left you may want to include this in your cancellation policy.
Does your practice accept cancellations by email? Similar to voicemail, these may be acceptable to you if the email is timestamped with more than 24-hour notice, but this must be included in your policy manual.
Text Message Cancellations
My favorite method as a practice owner is text message cancellation. I may not want to check voicemail or email over the weekend, but if I receive a text message cancellation the first appointment on an otherwise busy morning I will usually appreciate the notification and use that time accordingly.
Your policy manual should indicate whether you accept text message cancellations and what telephone number that message should use.
Everything you need to know about Medicare part B billing for physical therapists, occupational therapists, and speech language pathologists.
If you have been thinking about starting a brick and mortar private practice, mobile practice, or side hustle, this course will provide you with the tools and confidence to get started.
Lifetime access $499
How to Obtain a Handicap Parking Permit in Ohio: A Comprehensive Guide Handicap parking permits are essential for individuals with disabilities, as they provide convenient and accessible parking spaces. In Ohio, the Bureau of Motor Vehicles (BMV) oversees the issuance...
How much does Medicare pay for physical therapy This article will specifically reference the Medicare Part B Physician Fee Schedule look-up tool to determine how much does Medicare pay for physical therapy. Medicare Part B payment rates for a physical therapy initial...
1. Understand Your Ideal Client Everything begins with knowing who your ideal client is. If you are focused on treating post surgical total knee referrals you will want to choose a physical therapy clinic location with easy access parking, no stairs or curbs, and wide...
Which providers are allowed to certify a Medicare physical therapy plan of care? There are several types of healthcare providers that are allowed to certify a Medicare physical therapy plan of care. Medical Doctor Doctor of Osteopathic Medicine Nurse Practitioner...
My mom asked me "How long do physical therapy sessions take?" not because she was so eager to go, but rather because she wanted to get it over with.https://youtu.be/jwneMxD1jKsThe average physical therapy session at my clinic, Total Therapy Solutions, will last...