General

10 - General (Rev. 1, 10-01-03) B3-2020 This chapter provides claims processing instructions for physician and nonphysician practitioner services. Most physician services are paid according to the Medicare Physician Fee Schedule. Section 20 below offers additional information on the fee schedule application. Chapter 23 includes the fee schedule format and payment localities, and identifies services that are paid at reasonable charge rather than based on the fee schedule. In addition: • Chapter 13 describes billing and payment for radiology services. • Chapter 16 outlines billing and payment under the laboratory fee schedule. • Chapter 17 provides a description of billing and payment for drugs. • Chapter 18 describes billing and payment for preventive services and screening tests. The Medicare Manual Pub 100-1, Medicare General Information, Eligibility, and Entitlement Manual, Chapter 5, provides definitions for the following: Physician; Doctors of Medicine and Osteopathy; Dentists; Doctors of Podiatric Medicine; Optometrists; Chiropractors (but only for spinal manipulation); and Interns and Residents. The Medicare Benefit Policy Manual, Chapter 15, provides coverage policy for the following services. Telephone services; Consultations; Patient initiated second opinions; and Concurrent care. Chapter 26 provides guidance on completing and submitting Medicare claims.