Wiki Ketamine Infusions: Performed in Facility: Monitored by Physician

[CrysLednum]

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]

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.

 

[SharonCollachi]

Why are you providing the personnel and not the hospital?

 

[CrysLednum]

Thank you for the response. And yes, great question as to why we are staffing. I am pushing back to infusion clinic.

thanks!