Switching to Medicare During an Episode of Care

June 27, 2016
Rick Gawenda

I am often asked how to report Functional Limitation G-codes and PQRS codes on patient’s who began therapy with a commercial insurance (i.e. BCBS, Aetna, Cigna, UnitedHealthcare, etc.) as their primary insurance and during the therapy episode of care, Medicare becomes the primary payer. In this article, I will answer this question. In addition, check out our FAQs on Functional Limitation Reporting and 2016 PQRS.

Regarding Functional Limitation Reporting, on the first visit that the Medicare program is the primary payer, the provider would need to

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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

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