Site-of-Service Payment Differential To Be Implemented

Most payers, including Medicare, pay a site-of-service differential. In the next few weeks, Priority Health will be implementing this type of payment differential for some services performed in a physician's office versus when they are performed in a hospital.

Medicare Criteria To Be Used
To avoid confusion, Priority Health is using the established Medicare criteria to determine which services are appropriate for the office setting.

Reasons for the Change
This change reflects our commitment to making sure members get the right services, at the right time, in the right setting. In order to do this, payment must be aligned with the preferred setting. This payment change provides an incentive for physicians to perform appropriate services in their offices when the services can be done safely and effectively. 

Details on this change will follow in the coming weeks.