Billing for Services When Medicare Is a Secondary Payor
March 10, 2021MLN Matters Number: SE21002 Article Release Date: February 23, 2021
Key Reminders:
- Collect full beneficiary health insurance information upon each office visit, outpatient visit, and hospital admission.
- Find the primary payer before submission of a claim, and bill the proper responsible payer(s) for related services.
- Check Medicare Eligibility to identify accident or injury diagnosis codes for L, NF, or WC MSP periods.
- For multiple services, bill each responsible payer(s) separately.
- If you give treatment to a beneficiary for accident-related services and non-accidentrelated services, don’t submit both sets of services on the same claim to Medicare. Send separate claims to Medicare: one claim for services related to the accident and another claim for services not related to the accident.
- You should always use specific diagnosis codes related to the accident or injury. Doing so will promote correct and prompt payments.