Ketamine Infusions: Performed in Facility: Monitored by Physician

CrysLednum

Guru
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106
Location
Charm City - Baltimore
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Hi -

We provide ketamine infusions in an outpatient clinic where the hospital is billing the ketamine infusion codes. Our pain docs are providing monitoring during the 4-hour infusions (either MD or NP/PA) to check on vitals, complications, events etc. We have been informed that since the hospital is billing unless we are providing an unrelated charge we can't bill an E/M service for our physician services. Has anyone had experience with this scenario?

much thanks,
Crystal
 

thomas7331

True Blue
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2,851
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7
I agree with this - for infusions given in a facility, the hospital is responsible for the supervision of the nursing staff that is performing the service. The physicians cannot bill for this unless they are performing a separately identifiable and medically necessary service for the patient during the same encounter.
 
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