Medicare Payments for Long-Term Care Visits



Medicare payments comprise the vast majority of income derived from Geriatric/Long-Term Care medicine. Historically Medicare has been labeled a poor pay source, but I disagree.

Medicare is the primary pay source for most Americans over the age of 65 and those who are disabled. Compared to private insurance or to private pay, Medicare rates may be lower. However, the majority of your patients don't have private insurance and aren't private pay. That’s quite alright. Medicare payment is more than adequate.

Medicare physician payments for 2009 have actually increased by approximately 3-5.9% across all Long-Term Care codes.

Here are the main procedure codes for Long-Term Care patients with the fees.

Initial Visit:

99304---- $80.07
99305--- $111.81
99306--- $143.55

Follow-up Visit:

99307----$39.67
99308----$60.59
99309----$80.43
99310---$118.66

Annual Visit:

99318----$83.67

Discharge Visit:

99315----$58.07
99316----$75.74

The most frequently utilized codes are 99306 for admission/ readmission, and 99308 for follow-up visits. These payments if coupled with efficient, effective and frugal business practices can and do yield more than adequate income.



Data obtained from The Centers for Medicare and Medicaid Services (CMS).
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