Practice Management Alert

Question: Must we collect a copayment for a visit with a nurse?
 
Texas Subscriber

 
Answer: You must collect a copayment if the visit with the nurse is a chargeable, medically necessary visit. In other words, if the visit with the nurse is coded and charged, the patient must pay the copayment.
 
That does not mean, however, that a practice can charge for every patient who sees the nurse and collect a copayment. For example, if the patient sees the nurse for a blood-pressure measurement because the physician, as a courtesy, told the patient to stop in any time and have the check, there is no medical necessity to code the visit and, therefore, it is not charged. As a result, no copayment can be collected. But, if the physician gives written orders that a patient needs to come in for blood-pressure checks and medication monitoring with the nurse, medical necessity exists to code the nurse visit and charge it. The copayment must be collected.