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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:;-reimbursement

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