If a provider uses two separate fee schedules, one for Medicare and one for the rest of his business,
could he be liable for discrimination?
Assuming the Medicare fee schedule is the lower of the two,
there is no discrimination from a regulatory standpoint. In fact, you should not charge a Non Medicare patient
a fee lower than the fee you accept from Medicare.
From an operational standpoint, we do not recommend the use of two fee schedules unless you are a
non-participating provider with Medicare and you are required to bill your limiting charge.
(See our response to the Topic, Medicare Reimbursement) Otherwise, the use of a single fee schedule
Russell Still (bio...)
Executive Vice President
MMA does not provide
legal, accounting, or tax advice. If you need assistance in these
areas, we recommend that you consult a qualified professional. In
addition, please note that a client relationship with MMA is not established
by the submission of a question to this forum or by the publishing of MMA's