Provider Visit with Family Only

[kimberlydegrazia]

We have a provider that had a 25 minute meeting with a patient's family but the patient was not present. Can we bill for a Level 4, 99214 for time spent with family?

Thank you.

 

[mhstrauss]

We have a provider that had a 25 minute meeting with a patient's family but the patient was not present. Can we bill for a Level 4, 99214 for time spent with family?

Thank you.

Per CPT guidelines, in the Established Patient codes, description reads "__ minutes are spent face-to-face with patient and/or family". So looking at this, it is fine to bill the visit without the patient being present. However, you need to check with the payer also. Medicare will not cover a visit without the patient, but we have questioned some of our commercial payers, and they do allow this.

Hope this helps!

 

[kimberlydegrazia]

thank you