Question Physician clinic billing

Balmain55

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If a physician uses a treatment room at a hospital for their clinic visits, can you bill a 99213 on a physician claim and bill it again on a clinic claim? So you would have a 99213 billed on a 1500 and a 99213 on a UB.
 

thomas7331

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Yes, the physician will bill 99213 with a place of service 22 or 19, which will pay a reduced rate since the fee will only include physician work and not include reimbursement for the space and staff. The hospital will bill for the use of the clinic space on the UB form, usually with revenue code 510, and the CPT code could be the same or different since it is based on resource use and not on the E&M level criteria. For Medicare patients, the HCPCS will be G0463 since they no longer accept the office E&M CPT codes from hospitals.
 
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