reneedanielle22

Networker
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Waxhaw, NC
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Cpt 96365? Nobody knows???

Do not report for services provided by physicians or other qualified health care providers in facility settings.

What does this mean exactly for CPT 96365? I am so confused

Can an CRNP or MD in an outpatient facility bill for 96365?
 
Last edited:

thomas7331

True Blue
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When you see this instruction for a code, it means that it is a service that when done in an facility is performed by the facility's employees and is the responsibility of the facility to bill on the UB claims. Payment for these services is usually included in the facility's case rates and is not separately reimbursed on a professional claim. The code should not be billed by an MD or mid-level provider in that setting - it is only allowed when the services are performed in their own offices.
 
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