Medicare pays out billions for 'upcoding'

Tuesday, September 18, 2012

WASHINGTON – Doctors and other medical professionals have added $11 billion or more to fees for Medicare beneficiaries over the last decade through “upcoding,” according to a new report from the Center for Public Integrity. Upcoding is the practice of charging for more costly services than are actually delivered. The report found that, between 2001 and 2010, doctors billed Medicare for longer, more complex office visits despite there being little hard evidence that patients required more complicated and time-consuming care. The investigation also found that more than 7,500 physicians billed the two top paying codes for three out of four office visits in 2008, and that “the most lucrative codes are billed two to three times more often in some cities than in others." FMI: