Your Guide to Medicare’s Rates
Locating insurance rates can be really frustrating, more commercial insurers hide them deep in their contracts…but Medicare actually posts them online! Making it very easy to figure out how much you’ll get paid.
Each region (MAC) has a different fee schedule. You can view the map of regions and access the links to the fee schedules for your MAC right here on my website:
Once there, you’ll put in the CPT code, ensure it’s the correct locality (some states have more than one area and each may have a different rate), and look at the rate for participating (par) and non-facility (if you’re in private practice). Remember, masters-level clinicians get 75% of the posted rate. That will give you the FULL rate you can expect which would include the 20% coinsurance.
I hope this helps! Remember to check the pinned posts in the group and the videos under the “media” tab for free info.
I know becoming a Medicare provider can feel overwhelming. After years of doing all the Medicare billing and training for my group practice of 15, I started the Medicare Facebook group to help other therapists and healthcare professionals understand that Medicare isn’t as bad as it seems!
If you need more help, my Medicare courses include lifetime access and unlimited replays. You can view those here.