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Can I bill for these services?


Best answers

I have a pediatric provider who's patient ran away and the family presented with paperwork that needed to be completed and wanted to discuss the matter with the provider. Can I bill for the providers time that she spent completing the paperwork and meeting with the family?
Best answers
Depends on a few things. What do you mean by "bill"? If you mean bill to the insurance, the answer is typically no. From my experience, almost all carriers follow the Medicare guideline of face-to-face requirement to bill an E&M.
There is a code under psychotherapy 90887 "Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient." Whether or not your physician's discussion with the parents meets this description is another factor. Not to mention I have yet to encounter an insurance that will pay for 90887.
Similarly, CPT 99080 "Special report such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form" exists for the paperwork, but again never heard of a carrier paying for it. Many offices (not mine), do charge the patients for completing forms.
I would only consider billing E&M to insurance IF you are 100% certain the carrier permits E&M without patient present, which is not typically the case.

My personal opinion about this matter is that I can't imagine this is something that is a frequent policy. I would consider my doc's time assisting the parents during this heartbreaking situation as her good deed for the day and not charge the family or insurance for her time.