Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 100.1

Physician’s Services Furnished to a Dialysis Patient Away From

Last amended: 2021Year: 2021Length: 199 wordsOfficial source
100.1 - Physician’s Services Furnished to a Dialysis Patient Away From Home or Usual Facility (Rev. 10640, Issued:08-06-21, Effective:09-07-2021, Implementation:09-07-21) When a dialysis patient whose attending physician receives a monthly payment receives maintenance dialysis services of any kind outside the usual setting from any physician who is neither the attending physician nor that physician’s substitute, the following procedures apply: • The physician who furnished the service submits a claim to the local A/C MAC (B) of jurisdiction; • The A/B MAC (B) will process the claim and send an MSN to the patient; • The A/B MAC (B) that has jurisdiction over the usual dialysis setting adjusts the MCP to the usual attending physician to account for the time the patient was absent from the usual dialysis setting. • The A/B MAC (B) that has jurisdiction over the usual dialysis setting adjusts the MCP to the usual attending physician per §140.3.E below to account for the time the patient was absent from the usual dialysis setting. A/B MACs (B) must notify physicians that claims for services furnished to temporary patients must be identified as a claim for a temporary patient. The physician must indicate “temporary patient” on the claim.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 8 § 100.1: Physician’s Services Furnished to a Dialysis Patient Away From | Justis AI