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OIG Report Identifies Overpayments to Physicians for Incorrect Place of Service Codes

The Department of Health and Human Services Office of Inspector General (OIG) published a report finding that Medicare contractors overpaid physicians an estimated $13.8 million for services provided during calendar year 2007 with incorrect place of service codes.  The OIG report reminded physicians that they must identify the place of service on health insurance claim forms submitted to Medicare contractors.  This is because physicians are reimbursed at different rates depending on where the services are performed.

In addition to its identification of common billing errors, OIG recommended that the Centers for Medicare and Medicaid Services (CMS) instruct its Medicare contractors to recover the overpayments found from the services OIG sampled for its report.  OIG also encouraged the CMS to reopen nonsampled services to recover any overpayments and to continue its effort to educate physicians and billing services on the importance of identifying the place of service in Medicare billing records.

Providers should ensure that their billing practices follow the Medicare requirements, including proper place of service codes.

For more information on proper Medicare billing practices or for assistance with defending a Medicare audit, please visit or contact a Wachler & Associates attorney at 248-544-0888.

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