Coding & Reimbursement: Part C Medicare vs Traditional Medicare
Date: June 1, 2024
We can expect enrollment in Medicare Part C, or Medicare Advantage (MA), to continue its two-decade long trend of growth. According to the Kaiser Family Foundation (KFF), MA enrollment in 2023 was 30.8 million or 51% of eligible beneficiaries.1 The Congressional Budget Office estimates that enrollment will rise to about 61% of eligible beneficiaries by 2032;2 the growth can be attributed to the strong financial incentives Congress created for plans in the Medicare Modernization Act of 2003. In 2023, more beneficiaries elected MA plans instead of traditional Medicare, with significant ramifications for providers.
Of note, the reimbursement and covered services for MA plans can be different from Medicare Part B plans. This article helps to outline the difference between the two programs and hopefully help your practice decrease the administrative burden of insufficient claims.
Published in: Ophthalmology Management
Written by: Corcoran’s Consultant, Brandy H. Sperry, COMT, COE, CPC, CPMA
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