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Internal Medicine Coding Alert

Reader Question:

Billing for Travel Time

Published on Fri Mar 01, 2002 Print Friendly and PDF PDF

Question: One of our elderly patients with multiple medical problems was traveling through a rural section of California when she had an automobile accident. She sustained a hip fracture and underwent surgery at the local community hospital, located about 150 miles from our urban area. Both the patient and her family were concerned that the local internists were not able to manage her complicated medication regimen. The family requested that our physician visit the patient and consult on her care. Because she is a long-time patient, our physician traveled to the rural hospital to see her. Can we get paid for the travel time and expense?

California Subscriber

Answer: Yes, in this case, you may find that your Medicare carrier is willing to reimburse you for your travel time and expense. While travel to and from local hospitals, nursing homes and other facilities is not reimbursable, Medicare does recognize extraordinary circumstances when travel should be paid. Medicare's national operational policy on unusual travel states:
 
A. Unusual travel will be covered by Medicare Part B in those rare cases where the following conditions are met:

  1. The distance to be traveled is unusually long (e.g., over 100 miles each way); and

  2. There are no other physicians qualified to perform the service within that distance of the hospital.

B. A report must be sent with the claim describing the circumstances and distances involved. This will be reviewed on a case-by-case basis. Only one trip will be paid regardless of the number of patients seen or services provided. 

 
Because your physician traveled over 100 miles each way, your carrier would need to determine that your patient was correct in her judgement that none of the local physicians were qualified to manage her care in order to reimburse you. Bill your travel time and expense with 99082 (Unusual travel [e.g., transportation and escort of patient]) and be sure to include a report and a cover letter. Cite Medicare Carriers Manual section 15026 and national coverage policy PHYS-054 in your cover letter.

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