| The physician is reimbursed for
the interpretation of the test by billing against CPT
Code 91065 with a suffix of 26 (91065-26).
Metabolic Solutions is reimbursed for the test kit and
laboratory service by billing the patient’s health insurance
against CPT Code 91065.
Metabolic Solutions is a contracted provider for:
- Blue Cross / Blue Shield
- Medicare
- Tricare
- Humana / ChoiceCare
- MagnaCare
- ASMED Health Partnership
- Qualchoice
- UMWA Health and Retirement Funds
- Medicaid in all states but Florida, Massachusetts
and Kentucky.
Metabolic Solutions always accepts
the allowed charges and only bills patients when the
insurance company instructs us to collect deductibles
or co-insurance payments.
For subscribers to medical plans where Metabolic
Solutions is not enrolled as a provider, there
is often coverage through either an out-of-network
benefit or by getting a pre-authorization. Preauthorization
is easy to obtain because there is seldom an in-network
option. Metabolic Solutions accepts as payment
in full the “reasonable and customary”
fees established by each insurance company.
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