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Thread: Outpatient Hospital billing 99211

  1. #1

    Default Outpatient Hospital billing 99211

    Are providers in POS 22 able to bill out incident to E&M 99211 for a nurse only visit? (If incident to criteria is met)

    Example: Patient comes in for a nurse only visit.
    Facility - Nurse E&M
    Professional -( ? ) 99211 or (?) no billing

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    no the provider may not bill, the nurse is an employee of the facility and cannot provide incident services for the physician, and incident to does not apply to the facility setting. The facility may charge whatever level is met by their own facility criteria for E&M levels , regardless of whether the provider can charge.

    Debra A. Mitchell, MSPH, CPC-H

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