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Thread: Billing Family for in office consultation

  1. #1

    Question Billing Family for in office consultation

    Please clear this up for me. I thought a provider could not bill Medicare for consultation with family members about the patient if the patient was not present?

    If so what code would be appropriate.

    Thanks for your input.

  2. #2
    Join Date
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    York, Pa
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    Quote Originally Posted by kpennington View Post
    Please clear this up for me. I thought a provider could not bill Medicare for consultation with family members about the patient if the patient was not present?

    If so what code would be appropriate.

    Thanks for your input.
    Correct, Medicare does not pay for non face to face visits period.

    This question came up just recently on this board, what our practice does in this case is this.

    If the pt's family is requesting a "consult" to discuss the pt, they are made aware up front that they will be charged, not any insurance company. We book it just like a regular appt but for 30 minutes in the doctors schedule and we bill a flat fee and fee is due at the time of the service.

    Once the appointment is made, we send out a form letter explaining the procedure but also let them know this over the phone at the time the appointment is made.

    We haven't had any problems/issues with this from any family members to date.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


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

  3. #3

    Default

    Thank you very much for your response.

    I was pretty sure that I was thinking correctly.

    Have a great day!!

    Karolyn

  4. #4

    Default billing family

    This situation occured recently in are practice, the only difference it was in a hospital setting. What would you recommend us to do in this setting.

    Should we have the physician meet with the familly and patient after his exam, and document his meeting with family and time spent.

    Not sure how to handle?

    Thanks,
    Yvette

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