Advertisements are being sent to doctors via facsimile in various parts of the United States from a California company asking them if TENS/EMS units are presently being prescribed to patients for home use? If not, this company reports that they can show how to give patients drug-less pain relief and add a new profit center to the doctors office with TENS/EMS.
The company says their program is simple – they sell TENS to doctors for $29.00 (when 2 or more are purchased) EMS for $38 (when 2 or more purchased) and instruct the doctor on billing procedures for the TENS and fitting fee where the profits range from $200.00 to $600.00 per unit depending on the type of insurance coverage and amount charged for the unit/fitting fee. Next, the company indicates that they provide the patient with necessary supplies (batteries, pads & wires) and will bill the insurance company direct.
Good deal? Maybe.
Many state regulatory boards have prohibitions against excessive charges for health care services rendered – could the billing insurers $200 to $600 for providing a patient with a TENS the doctor purchased for $29 be considered excessive? What would the involved payer think of this activity – are they going to knowingly pay $200 to $600 for your providing the patient with a $29 TENS unit? And, what happens when insurance doesn’t pay – is the patient going to be billed the higher rates for the $29 unit?
I would recommend that doctors ensure that this practice activity is consistent with their administrative laws, third-party payer rules and to check it out first with their attorney prior to use.