CMS rules and family ties – Ophthalmology Management

We all know that Medicare prohibits charging for services to immediate family members, but the big, recurring question that we receive is: what does this really entail?

This article addresses the following questions:

• Why doesn’t Medicare allow claims for services to family members?
• What are the excluded relationships?
• How does Medicare define “immediate relative”?
• Who does CMS consider to be members of a household?
• Does the exclusion apply to other providers in the practice?
• What about corporations?
• What about Medicare Advantage (Part C) plans?

This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below:

https://www.ophthalmologymanagement.com/issues/2019/july-2019/coding-amp;-reimbursement