Welcome to the Medicare Part B Playbook
Whether you're a solo therapist looking to become more competent working with your Medicare Part B beneficiaries, a cash-based provider navigating who you can charge, when to use an ABN, and how to stay compliant, or an experienced clinician or practice owner seeking clarity and confidence in determining whether your patient requires restorative or maintenance care...the Part B Playbook can help!
The Part B Playbook is more than just a guide—it’s an interactive tool designed to streamline your clinical decision-making when working with Medicare B beneficiaries. Drawing directly from the Medicare Benefit Policy Manual, Chapter 15, this resource references the original guidelines while adding examples and context for clarity.
Just like a ‘chose your own adventure’ book, the Playbook walks you through the questions you’ll need to answer when working with Medicare B beneficiaries, in order to:
Determine whether the patient in front of you (or on a discovery call) should be seen under their Medicare B benefit or as a wellness client.
Decide if a patient belongs on a restorative or maintenance plan of care.
Know exactly what to do when a patient’s condition or situation changes.
Understand when you need to use an ABN form and how to implement it appropriately.
Determine when to perform reassessments to remain compliant with Medicare guidelines.
DISCLAIMER: Please note that this tool is intended for educational purposes only and is designed to support - not replace - your clinical judgment. It does not provide guarantees of compliance, audit protection, or legal defense in the event of Medicare investigations or disputes. Users are responsible for ensuring their own adherence to Medicare policies and making sound clinical and administrative decisions based on each unique patient circumstance.
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