Wiki Hospital (21) vs. Office (11)

[carriebeth]

Hello Everyone

My background is office & professional coding; hospital is foreign to me.

*All fees are the national price
Lets say I am coding a 37224 in a POS 11 the MPFS states we will get $4125.59
If my doctor does 37224 in a hospital we will get $468.16

What does the hospital get? Do they charge the same as I do in a POS 11? I have looked at the 'Physician Fee Schedule Search Tool' on the CMS website but I can not figure it out.

Thank you for any help !!!

 

[mitchellde]

When you perform the procedure in the POS 11 the provider is compensated for his time and skill as well as all office overhead. When performed in the hospital POS 21 the provider is compensated for time and skill only. For the hospital fee schedule you might need to look under part A.

 

[lorrpb]

Inpatient hospitals are paid based on the MS-DRG rate. This rate includes not only the procedure itself, but the inpatient room and board, nursing services, etc. for the entire inpatient stay.