Wiki POS for 90791

[Blackhorse]

Anyone knows if we can use 90791 with POS 55? I know we can bill it with POS 11, how about POS 21, 22, 24, 52, 53, 54, 55,56?

 

[thomas7331]

Yes, it can be billed with those POS codes for services performed in a facility. It will be reimbursed at a slightly lower rate because you're only getting the provider's professional costs paid and not the facility/office costs.

 

[Blackhorse]

Yes, it can be billed with those POS codes for services performed in a facility. It will be reimbursed at a slightly lower rate because you're only getting the provider's professional costs paid and not the facility/office costs.

Thank you. Can we bill it on UB-04?

 

[thomas7331]

Thank you. Can we bill it on UB-04?

The facility will bill their portion on the UB-04; the professional services go on the CMS-1500, unless the provider contract specifies otherwise.

 

[Blackhorse]

The facility will bill their portion on the UB-04; the professional services go on the CMS-1500, unless the provider contract specifies otherwise.

So facility does bill it with the facility NPI and get paid? I just like to make sure facility can bill it also.

 

[thomas7331]

So facility does bill it with the facility NPI and get paid? I just like to make sure facility can bill it also.

The facility can bill their portion under their credentials if the service was performed on their premises. Whether or not it will get paid is going to depend on the facility's contract, the patient's benefits and the payer's reimbursement policies, so I really can't answer that part.

 

[Blackhorse]

The facility can bill their portion under their credentials if the service was performed on their premises. Whether or not it will get paid is going to depend on the facility's contract, the patient's benefits and the payer's reimbursement policies, so I really can't answer that part.

Thanks a lot for your help. Appreciate it