Forum - Questions & Answers

Apr 8th, 2009 - mmbittner

Facility Fee Billing for outpatient services

We are a Family Physician/Resident Program at a hospital. We have been determining what level of facility service should be chosen for our services. Does anyone out there have a criteria an place we can compare to.

Apr 8th, 2009 -

What services?

If you are offering E&M physician services 99201-99215 I doubt you can charge for a facility fee. If you are an urgent care there are facility codes although I just read that UHC is going to phase out that fee (but don't quote me.)

Apr 8th, 2009 - kbarron 4 

Facility Billing

Are you a CAH? We are and have to break out the facility fee from the physician fee.

Apr 9th, 2009 - Codapedia Editor 1,399 

Facility Fee Billing for outpatient services

CMS allows facilities to determine this for themselves, which doesn't always help, does it?

ACEP has a set of criteria for ED visits. I know you're asking about office services (the facility component) but perhaps this would help you to set up the criteria.

Here's the link.

http://www.acep.org/practres.aspx?id=30428



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