I have a few questions and hope someone here would be a great resource with some help! My first question is about contractual obligations/adjustments. Normally practices/providers have their charged/billed amount as above the medicare allowable. So say they bill 99214, $ 125 is their rate/charge. The insurance allowable is $ 62.50, pt has a $ 10 copay and the contractual obligation(adjusted/write off) would be $ 52.50. Is it legal for a provider/practice to bill their allowed amt as the charged amount so they don’t have to take any write off/contractual obligations? So if the allowable for 99214 is $ 62.50 that would be their charged/billed amount to the insurance.

And secondily, has anyone worked with ABA therapy codes? I have a few questions in regards to coding and billing some codes and wanted some insight. So was looking for someone I could email and pick their brains on a few things.

Thank You!

Hopefully I wasn’t too confusing!