Suppliers of all kinds are leveraging advanced technology to monitor patient compliance, improve insurance documentation accuracy, and reduce administrative costs. Many, however, wonder if the monitoring services are separately billable to the insurance carrier or patient.
They are not.
While it is possible to bill for non-covered devices using HCPCS A9279, monitoring services are never separately billable. A9279’s definition is clear that it is for stand-alone or integrated devices; there is no mention of services.
Because Medicare denies claims for A9279 devices as statutorily non-covered, suppliers can elect to collect payment from beneficiaries. Regardless, suppliers cannot bill for any related services. ABNs for monitoring services are invalid, and erring suppliers will have to refund beneficiaries for all amounts collected.
Should you find yourself wondering if you could be using that A9279 HCPCS you saw in the PAP and RAD LCDs, just remember:
They are not.
While it is possible to bill for non-covered devices using HCPCS A9279, monitoring services are never separately billable. A9279’s definition is clear that it is for stand-alone or integrated devices; there is no mention of services.
Because Medicare denies claims for A9279 devices as statutorily non-covered, suppliers can elect to collect payment from beneficiaries. Regardless, suppliers cannot bill for any related services. ABNs for monitoring services are invalid, and erring suppliers will have to refund beneficiaries for all amounts collected.
Should you find yourself wondering if you could be using that A9279 HCPCS you saw in the PAP and RAD LCDs, just remember:
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