I agree with everything Wendell said. Medicaid is easier to deal with than private insurance. Luckily, in Houston, the two largest Medicaid HMOS are nonprofits and working with them is much easier than working with UHC, BCBS, etc. I also used to work for a surgeon so I did some Medicare billing and also agree with Tom. I'd rather have the clarity of Medicare policies than wading through different policies, forms, formularies of private insurances. To get a fee for a procedure from medicare or medicaid, I just have to look at the right webpage. To get a fee schedule from a private insurance company usually involves multiple steps, taking many days, sometimes weeks or calling and emailing different people.