Wiki copay for Regular Visit & Specialty

[lizad7@hotmail.com]

Can somebody explain to me when we should charge specialty visit copay vs. regular visit copay? For example I work with an oncology specialist, and BCBS has a $25 regular visit copay and a specialty visit copay of $40. Should we charge $40 copay for a 99214? Thank you...

 

[CodingKing]

There are plans out there where the PCP copay is lower than the specialist copay. This sounds like one of these cases where you should charge $40 but if in doubt call the payer.