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Neurology & Pain Management Coding Alert

Reader Question:

Understanding Transitional Facility vs. Nonfacility

Published on Sat Jan 27, 2007

Question: What is the difference between a transitional nonfacility and a transitional facility? I-m not sure which one our group belongs to or which total RVU group to reference when determining charges. North Dakota Subscriber Answer: If your physicians provide services in any type of doctor's office, you are a transitional nonfacility provider. Understanding the difference and reporting your location correctly is important for accuracy and for reimbursement, as you know: for 2007 the total RVU for a transitional nonfacility was 2.56 and for a transitional facility was 1.90. Some carriers (such as North Carolina Medicare) simply refer to locations as facility or nonfacility. Check your carrier's terminology to further understand what they mean by each term.
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