Friday, May 28, 2010

"I'm a Medicare doctor. Here's what I make"

From CNN:

Dr. Schreiber sees 120 patients a week - 30% of them are enrolled directly in Medicare, while another 65% have private insurance plans that peg their payments on Medicare's rates. Only 5% pay on their own.

Medicare pays between 63-72% of the costs for Schreiber's patients.

Four billing codes make up the "bread and butter" of claims submitted to Medicare:

- The first code represents a simple visit, which might include blood pressure and cholesterol checks. Schreiber gets about $44 from Medicare for the $70 fee he charges.

- The second and third codes correspond to a sick visit, when he spends 15 to 20 minutes evaluating a patient for symptoms such as coughing or shortness of breath. Schreiber charges $92 for a sick visit, of which Medicare pays about $58.

- The last billing code is a complex visit. "This is where a patient comes in with many problems like heart disease, hypertension, diabetes," he said. Such a visit requires about 30 minutes of his time.

Schreiber charges $120 for these visits, and Medicare pays $88 of that.

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Image source: United States one-dollar bill. Wikipedia, public domain.