Forum - Questions & Answers
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.
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.)
Facility Billing
Are you a CAH? We are and have to break out the facility fee from the physician fee.
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