Do I need to edit my fees for Medicare thresholds?


No, you do not need to edit your fees to account for Medicare thresholds. Medicare will confirm whether or not a patient has reached a threshold once it processes the claim. It will then pay the correct amount in accordance with the threshold regardless of what you have entered in the Rebate section of a fee. This will be denoted by an appropriate explanation code when you click Get Report or View Report on the invoice after submitting the claim.

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