Forum - Questions & Answers
Hospital Treatment Rooms - Not ER
We are a new hospital specializing in pain management. We bill on the facility side only and are out of network at this time.
If we are billing for the use of a treatment room (not ER) for office visits:
Is the revenue code 761?
Are the CPT® codes the same as office visits (i.e., 99215)?
Is there a modifier we are supposed to use?
I do not want it to look like we are double dipping with the physician side.
They seem like simple questions, but I am having trouble getting the answers. Can someone help me?
re: Hospital Treatment Rooms - Not ER
Yes on all counts, but you do not need a modifier. Also look at revs 510,511 if it applies to you. If you're performing a procedure the visit may be included/bundled then you would need to decide if to bill the visit at all or throw a mod on it. Don't worry about double-dipping. If the payer reimburses you that means they allow payment for your fac/technical visit. You'll know right away if they do not like it, they won't pay you.