Awareness : OBC Tips

Which Services Are Billed to Original Medicare in Qualifying Drug Trials?

Follow the Medical Coverage Analysis (MCA). If the service is on the MCA (part of study schedule of assessments), then the service should be billed to original Medicare.  Example: protocol scheduled ECG. If the service has nothing to do with the study and is not scheduled by the protocol, then bill to the insurance.  Example: patient has tooth pain and requires root canal.  If the service is to treat a complication related to the investigational item, then the service should be billed to original Medicare.