it depends on your contract with the insurance for the two patients the physician did this for.
Medicare will not allow E/M codes at an asc such as 99214.
most insurances will follow this criteria. however, i have some contracts that if the code that was performed is not on their list of payable codes for an asc, then we get reimbursed at 40% of billed amount up to a maximum payable.
it would be best for you to talk to the person at your facility who maintains your contracts and ask him/her to get the OPG lists for each individual commercial insurance. Then talk to your contractor and understand how your contracts will pay you if a code is not on that list.
hope this helps
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