Wiki IR consultations and facility charges

[AuditU]

Good evening,
If an IR provides a consultation service is there a corresponding "facility" fee? The question has come up with an IR wanting to perform consultations in the IR department of the hospital.

Thank you

 

[thomas7331]

If the physician has a dedicated provider-based office space in the facility and sees the patient for consultation in that clinic setting (similar to an office visit), then a facility fee can be billed (G0463 for Medicare). However, if the consultation is a part of a separate outpatient, observation or inpatient service for which the patient is in the facility (i.e. the physician is rounding on the patient who is in another hospital department), then there would be no separate facility fee for the consultation. The facility should direct you on this as whether or not a clinic visit should be charged will depend on the provider-based status of the IR department and how the facility's resources are used for this purpose.