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Facility Billing - no modifiers

  1. #1
    Default Facility Billing - no modifiers
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    Can an Urgent Care or a group of doctors bill as a facility? we are not afiliated to hospital, Can you give me an example on when a facility can bill for service?

    We have an xray machine, and a radiology doctor read and reports for what he bills us directly. in these case we are able to bill for the Xray ( no modifiers). am I correct? any thoughts?


    Thanks
    Saul S.

  2. #2
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    I work for a facility, the way we operate and have to bill is as follows:

    we own the equipment.

    we bill the technical component on a UB04, the read is billed on a 1500 with modifier 26.
    Stephanie Phillips, CPC-H
    sphillips@orhmi.com

  3. #3
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    the doctor's side of my practice bills global, with no modifiers, on a 1500. it's there equipment and they have their own contracted doctor that reads for them. is the radiology doctor billing the carriers for his read?
    Stephanie Phillips, CPC-H
    sphillips@orhmi.com

  4. Default
    You will have to add a TC modifier to receive payment for the technical portion while the the physician who reads and interprets will bill with the 26.

    Simone, CPC

  5. #5
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    We owe the equipement and ther ordering physician is one of our doctors. We are contracted with Radiology for the reading, meaning that we pay the Rad physician for readings. We bill global ( no modifiers) and use the ordering physicians NPI. I want to make sure we are billing correctly. We do not use
    UB04. Should i be using UB04 and TC/PC?
    is it correct to bill under physician'sn NPI? When we I use Group NPI?



    Saul

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