WHAT is PART B BILLING?
Two types of Medicare Services are involved in wound care:
PART A – Covers Inpatient hospital care, skilled nursing facility care, hospice care and home health care. Typically, PART A Medicare covers patients wound care while in the hospital and the 1 st 100 days in a nursing home. These services are included as part of the daily Medicare payment for patient care.
PART B – Covers physician services, outpatient care and other medical services which are not otherwise covered under PARTA Medicare. Generally, after 100 days in a nursing home, patients wound care treatments fall under PART B Medicare and are paid separately from daily care and other treatments.
Medicare Part A & Part B are NOT interchangeable! An important note about Medicare PART B Billing is that each patient must pay a premium each month; pay a yearly deductible and co-pay unless the patient has co-insurance. Part B is similar to having a regular commercial insurance plan. Difference being, Medicare PART B coverage only includes two (2) types of services:
- MEDICALLY NECESSARY SERVICES: Includes services and supplies needed to treat your medical condition. For patients to be covered, the service must be within the standards of medical practice. Meaning, holistic or naturopathic treatments are NOT covered.
- PREVENTIVE SERVICES: Includes healthcare services that are necessary for preventing illnesses rather than treating illnesses. Methods of early detection such as diagnostic exams for cancer are considered as preventive medicine. The Wound Pros team have specialized expertise in supplying wound care products the under PART B Medicare plan. Our team will ensure that your patients get the products they need and that Medicare Part B is properly billed.