Provided by JEFFREY D. LEHRMAN, DPM, FASPS, MAPWCA, CPC  

QUESTION:

Do MDs get paid higher for codes such as 99213 and SX codes such as 28296 than we do?  

ANSWER:

The answer varies depending on the payor and the contract you have negotiated with the payor. For Medicare, the answer is “no”. There is one fee schedule for your geographic area and every provider type gets paid the same thing for the same service. For non-Medicare payors, the fee schedule is negotiable. If one provider type negotiates a better fee schedule than a different payor type, they will make more money for the same service. There are many providers that just sign the contract offered to them without even attempting to negotiate their fee schedule and this often leads to discrepancies from provider to provider and between specialty types.