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I understand that the prices listed on the Medicare Fee Schedule are the Par fees, and that the Fee Schedule in WebPT is informational only, the fees are set by the MAC.
Previously, this pricing would be off by cents, but it is now off by dollars. This complicates adding the KX modifier on-time. Many clinics and people will be losing thousands of dollars if they are dependent on the WebPT program for that info - many of us are depending on this to be more accurate than it currently is. I have already supplied an EOB to Support showing the large difference in pricing.
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Hello, and thanks for your feedback! We update the Medicare Fee schedule values each year, but understand that these are difficult to track and keep accurate. We are considering how we can better leverage billing information to update this in the future.
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Try to addendum the notes to add the KX modifiers or check Novitasphere periodically to make sure they are not going somewhere else, which will cause the Part B PT cap to be off. I do not think it is reasonable to expect Webpt to monitor this. You can also change the Part B PT $ amount met on the insurance tab, within the patients chart.