Question
How do I find out how much I can charge for a 98941 for a Medicare beneficiary?
Answer
There are many factors involved. First, fees vary by geographic location. Then, if you are non-participating, you can bill the Limiting Charge. If you are participating, you will be reimbursed the Allowed Amount. Depending on your penalties from PQRS and/or Meaningful Use, that amount can be adjusted down further.
The official rules can be found here, and a CMS calculator is here. Those with Premium Membership can view the Allowed Amount on the code information page inside the ChiroCode Online Coding Library. For a more comprehensive discussion on Medicare fees, see Chapter 2.3 of the 2018 ChiroCode DeskBook. If you still have questions, call your Medicare Contractor and talk to their provider relations department.
