Plan N-No $20 Copay on Physical Therapy

[insurance0707]

I called both United of Omaha & AARP regarding Plan N and they both told me that physical therapy does not have a $20 copay. It has a different code # when billed. It's not billed as an office call but under physcial therapy. Medicare pays 80% and Plan N will pick up the other 20%

 

[DS4]

The office visit co pay applies to "office visits". An office visit consists of, health history, exam and diagnosis.
A trip to a physical therapist usually only involves "treatment".
The CPT billing codes will determine if the "office visit" co pay applies.

 

[insurance0707]

so you're saying possibly that the first visit might have a 20 copay but subsequent visits would not?

 

[G.Gordon]

What is Luke's view on this matter?

 

[DS4]

so you're saying possibly that the first visit might have a 20 copay but subsequent visits would not?

No.
RPT does not make a diagnosis. Therefore, CPT codes are all "treatment".
I really wish Luke would chime in.

 

[insurance0707]

I was just happy to hear that Physcial Therapy wouldn't be subject to the $20 copays. If a client is going 3 times a week for a couple of months, that could add up. No
one on this board seemed to know the answer to it....that's why I called AARP and United of Omaha directly

 

[DS4]

I was just happy to hear that Physcial Therapy wouldn't be subject to the $20 copays.

Your client will also be Happy to pay the $155 Part B deductible.

 

[luke4275]

Considering I didn't know what the part A ded was last week, I go with whatever Rick says

 

[insurance0707]

Your client will also be Happy to pay the $155 Part B deductible.

They pay the $155 Part B deductible under Plan G also...what's your point

Do you only sell Plan F?????

 

[DS4]

Do you only sell Plan F?????

Yes
By default though. Most of my carriers don't sell D, G or N.