Wiki CPT for parent & physician consult?

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New Albany, MS
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We had a parent call interested in scheduling a time to come speak with one of our pediatricians to see if our practice would be a good fit to provide primary care for her 4 children. The parent would be coming alone. All 4 of these children would be new patients. One child has severe special needs and another child has CPS1 that required regular visits to multiple specialists. The parent doesn't feel her needs are currently being met with her current PCP. Our pediatrician was wondering if this is something that she could bill for since it will have to be a scheduled visit during her regular clinic hours.
 
I am not aware of any insurance plan that would cover this type of service, as you are not providing medical care to a patient. Medicare has officially stated the patient must be present to receive the service.
I work in gynonc and every once in awhile, usually in unfortunate circumstances, the provider will meet with patient's family/caregivers without patient (who is usually inpatient hospital or hospice). We have decided as a practice to not charge for those very occasional situations.
You can make a business decision for your practice to charge a parent for the physician's time, or to consider it a cost of doing business.

PS - if the physician is meeting with family/caregivers on the same day as an E&M service with a patient, you can count that time toward that day's E&M.
 
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