Medicare 2016 Fee Increases – What You Need to Know

The Centers for Medicare and Medicaid Services (CMS) recently announced a new fee schedule for Medicare Parts A and B beneficiaries in 2016, increasing the annual and monthly payments for many of the millions of Medicare beneficiaries. While patients are ultimately responsible for familiarizing themselves with their co-pays and billing obligations, it is important for medical practices to stay abreast of changes to Medicare’s fee schedules annually, as well as throughout the year through initiatives like the income-related monthly adjustment amount (IRMAA) for individuals with higher incomes, in order to ensure proper reimbursement for services.

Medicare Parts A and B Fee Changes for 2016

Some of the price changes and fee increases for the coming year include:

  • Part B annual deductible will increase to $166
  • Part B monthly premiums will increase, with the exception of “hold harmless” provision beneficiaries including low income and social security recipients, dual eligible participants whose premiums are paid by Medicaid, and new enrollees in 2016

Other fee increases for Medicare beneficiaries in 2016 include:

  • Individuals with annual incomes between $85,000 and $107,000; and married couples with annual incomes between $170,000 and $214,000 – 2016 premium will be $170.50
  • Individuals with annual incomes between $107,000 and $160,000; and married couples with annual incomes between $214,000 and $320,000 – 2016 premium will be $243.60
  • Individuals with annual incomes between $160,000 and $214,000; and married couples with annual incomes between $320,000 and $428,000 – 2016 premium will be $316.70
  • Individuals with annual incomes of $214,000 or more; and married couples with annual incomes of $428,000 or more – 2016 premium will be $389.80

Medicare Part A Fees 2016

  • No Part A deductible for beneficiaries with at least 40 quarters of Medicare-covered employment
  • Premium will increase to $411
  • Deductible will increase to $1,288
  • Co-payment for hospital stay days 61-90 – $322 per day
  • Co-payment for hospital stay days 91 and up – $644 per day
  • Skilled nursing facility co-payment, days 21-100 – $161 per day

Contact a Medical Billing and Practice Management Expert Today!

Regular changes to Medicare and private insurer fee schedules are an inevitable part of life in the healthcare industry. But they do not have to catch your medical practice by surprise, or cost your practice valuable time and money!

Contact ML Medical Billing today to learn how we can take the stress out of the medical billing process, and ensure that all of your claims are paid and that your practice is fully reimbursed for its services, every single time! Call us today at (888) 719-7602 to schedule a consultation.

Try our free online profit calculator to learn about your practice’s individual earning potential today!

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