Wiki Cpt 99211-Can a medical assistant

AmyKarmol

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Can a medical assistant provide services to a patient and bill for CPT 99211 or is this code used for RN/LPN services only? Also, if not, is there any CPT code that can be used for a medical assistant for billing purposes?
 
Medical assistants cannot bill for anything. They fall under incident to guidelines and are billed by the physician doing the direct supervision.
 
The 99211 is a provider level of service. It is the only level allowed to be billed by the provider when qualified ancillary personnel are the one that is face to face with the patient carrying out orders from a previous physician encounter. Ancillary personnel includes the RN, LPN, MA. As long as the activity performed is not out of the scope the licensure of the person performing it.
 
if the nurse performs a chemo teaching and the physician is not in the building, can she still bill for a 99211 visit for that day? if I understood the previous comment, service could be provided based on the prior physician orders. Would this apply? Thank you.
 
Billing E&M 'incident to' requires direct physician supervision, so this could not be billed if provider was not in the building. CMS publishes a limited list of codes for therapeutic services that can be provided by staff under general supervision, which would not require the physician to be physically present in the building, but E&M is not included in that list.
 
99211 / 96372 MS vs. RN

Historically, these services have been provided by an RN and submitted under the supervising (ordering and in office suite) physician (based on order from the physician for the injection of a med or in the case of 99211, education and swab for genetic testing). Our RN is retiring and they are considering replacing that role with an MA. I am wanting to verify that billing these services when provided by an M.A. would be appropriate, but can't seem to find anything in writing.
Any input/link is appreciated!


Sincerely,
Gaelin Simson, CPC-A
 
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