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Thread: Can hospitals bill for Patient Education

  1. #1

    Smile Can hospitals bill for Patient Education

    AAPC: Back to School
    Again, I work for Flagler Hospital here in St Augustine FL. can someone help me understand or point me to the guidelines on billing for patient education. We do cancer, stroke and diabetes education for our patients currently at no cost. i know medicare has HCPC codes out there, but didnt know what the guidelines were or if anyone else was billing for this. Please help. Thank you in advance

  2. #2
    Join Date
    Apr 2007
    Adirondack Chapter of Professional Coders, Glens Falls, NY


    If you are doing education sessions for a group of patients, I think you could use this code: 99078 Physician educational services rendered to patients in a group setting (eg, prenatal, obesity, or diabetic instructions) The physician provides educational services to patients in a group setting. The topics vary according to the group but can include prenatal care, diet, diabetic instruction, and smoke cessation. I believe the ICD-9 would come out of the V65 group of codes, V65.3 is dietary counseling and includes diabetes education, and V65.4 is other counseling not elsewhere classified and includes health advice, education and instruction.

  3. #3

    Default Can hospitals bill for patient education

    Well, we are a outpatient hospital and I was hoping to get some knowledge on billing the technical part. Our trained RN's are providing this service and I believe this is possible. Anyone can help would be greatly appreciated.

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    look at 98960 - education and training for patient self management. This is a non-physician code for any qualified health care professional. I have used this in an outpatient setting and it was reimbursed , if you are doing groups then go 98961, 0r 98962 depending on the number of patients and it is for every 30 minutes.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5

    Smile Can hospitals bill for patient education

    Thanks for that. Very helpful. Does anyone know if there are guidelines out there to accompany the codes from Medicare?

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