One of our physicians wants a SNF resident, under a Part A covered stay, to come to the office for Botox injections. CPT codes would include J0585, 64614, and 95874. Part A Medicare says J0585 and 64614 are under consolidated billing - another source says only J0585 is under consolidated billing. My research on confirms what Part A Medicare told me, that J0585 and 64614 are under consolidated billing. But it makes sense that ony J0585 would be under consolidated billing, since 64614 is a professional service. Any guidance would be helpful.

Also, has anyone had any experience billing EMG codes, performed with your own EMG machine, on patients in a Part A covered stay, performed either at the SNF or in the office? Have you been reimbursed by Medicare for both the technical and professional components? Or only the professional component?

Barbara Coupe Bernal