Claims Submission
Claim Components
Billed Amounts
Providers are required to bill their usual and customary charge for services provided. The usual and customary charge is the amount charged by the provider for the same service when provided to private-pay patients. Providers may not discriminate against Wisconsin Medicaid recipients by charging a higher fee for the service than is charged to a private-pay patient.
Wisconsin Medicaid automatically deducts applicable copayment amounts from Wisconsin Medicaid payments. Do not reduce the billed amount of a claim by the amount of recipient copayment.
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Chiropractic Services Handbook
PHC 1306, October 2004