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Thread: Can you bill 2 copays for....

  1. #1

    Default Can you bill 2 copays for....

    AAPC: Back to School
    When a pt comes in for a preventative ov (99397) and a E/M (99213) can you charge 2 copays for the same visit?


  2. #2
    Join Date
    Apr 2007


    charge just one copay.

  3. #3


    That would depend on your payor. If it is an insurance company that charges copays for preventative care and also E/M visits then you can charage the patient for the two copays. You will be able to tell on your EOB's. If the insurance company is taking that copay amount out of the amount they pay you from their allowable amount, if you don't collect the copayment you are loosing money.

    If an insurance company pays you their allowable amount and doesn't subtract a copay amount then you cannot collect a copay.

  4. #4
    Join Date
    Apr 2007
    Greeley, Colorado


    I agree with Jacqueline - if the insurance applies a copay to each code, then the patient is responsible for 2 copays.

  5. #5
    Join Date
    Apr 2007
    Seacoast- Dover New Hampshire

    Default 2 copays

    Why would you charge two copays on the same date of service? It is still only one encounter with the Provider.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  6. #6
    Join Date
    Apr 2007
    Bettendorf, Iowa


    occasionally we have this happen when the patient is seen for E&M and happens to have treatment or lab on the same day and the billing doesn't go out at the same time. Or they get charged out under 2 different physicians. We don't charge the patient for 2 copays since they are recieving all services at the same facility on the same day.

  7. #7
    Join Date
    Apr 2007
    York, Pa


    Quote Originally Posted by chrisron View Post
    When a pt comes in for a preventative ov (99397) and a E/M (99213) can you charge 2 copays for the same visit?

    Sometimes it's a case by case basis, in our office if this happens we only charge 1 copay, we will just write one off.
    Roxanne Thames CPC, CPC-I, CEMC

    "Remember the greatest gift is not found in the store but in the heart of true friends"

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