Section 1833 (a)(1)(F) of the Social Security Act - Payment of Licensed Clinical Social Worker (LCSW) in a Method II Critical Access Hospital (CAH)
Physicians and non-physician practitioners billing on type of bill (TOB) 85X for professional services rendered in a Method II CAH have the option of reassigning their billing rights to the CAH. When the billing rights are reassigned to the Method II CAH, payment is made to the CAH for professional services (revenue codes (RC) 96X, 97X or 98X). Medicare makes payment for LCSW to a Method II CAH based on the lesser of the actual charge or 75 percent of the Medicare Physician Fee Schedule (MPFS).
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 27, 2011
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