Everything You Need to Know About the Medicare 8 Minute Rule – LIFESTYLE BY PS
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Everything You Need to Know About the Medicare 8 Minute Rule


When you are dealing with medical coding and billing with your practice, you should be especially mindful of how you handle Medicare patients. Things like the 8-Minute Rule come into play, and understanding these rules will help you to prevent mistakes that can add to your workload. 

But you might be wondering, what exactly is the 8-Minute Rule? How does it work?

If you'd like to learn more about the Medicare 8 Minute Rule, consider the tips in this article. 

Medicare 8 Minute Rule

What is the Medicare 8 Minute Rule?

The Medicare 8-Minute Rule refers to the practice of billing the provider for a full unit, provided that the appointment lasted at least 8 minutes. This rule establishes clear guidelines about what is billable and what isn't so that practices know what to do in the event an appointment is brief or cut short. 

There are all sorts of Medicare plans that patients use for their various treatments and appointments. 

Since your patients are constantly figuring out which is best for their medical needs, you should always be a good steward over your coding and billing practices when services are rendered. 

Here are some additional answers to questions that you might have regarding the 8-Minute Rule:

1. How Exactly Does it Work?

When a patient comes to your practice for an appointment, you will log it in your system with either a tie-based code or a service-based code. When you regularly track your appointment time blocks and make note of how long a visit lasted, you'll be better equipped to apply the 8-Minute Rule whenever it becomes relevant. 

If the appointment lasted anywhere between 8 minutes and 22 minutes, you will log it as a single unit. The number of units increase by a single unit every 14 minutes, before capping out at 6 units for any appointment that lasted 83 minutes. 

Mastering these medical billing and coding needs will improve your practice by leaps and bounds. It'll help you keep cleaner records and make sure that your patients' Medicare plans are correctly billed each time they make an appointment. 

2. Who Does the Rule Apply To?

The 8-Minute Rule for Medicare applies anytime that you provide service as a primary medical care practice, skilled nursing facility, outpatient hospital service, rehab clinic, home healthcare provider, and other relevant providers. 

Always make sure that this service applies to your business so that you can use it accordingly. 

3. What Should You Know About Using the 8-Minute Rule?

The more accurate your records, the better. You owe it to yourself to hire the help and service of a coding and billing contractor so that you can avoid errors. 

Make sure that you also use this rule if your patients have Medicaid or other federal program memberships. 

Tackle All of Your Coding Needs Head-On

When you understand the Medicare 8 minute rule, you can cut out mistakes with your billing and coding. By tackling all of your major coding and billing needs, your practice will have cleaner records and you're always a good steward of your patients' accounts. 

Check back for more answers to your medical industry and Guided meditation questions. 

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