Our hospital based providers "rent" space in hospital owned clinics / office buildings.
The hospital hires the nurses, lab techs, xray techs, etc, owns all the equipment, and provides virtually all the supplies.
The physician bills ONLY for the professional component of his services. The hospital (facility) bills for the facility charge, which is based on the nursing time and equiment/supplies used. They use either new patient or established patient codes, as they are not allowed to use consultation codes.
It's entirely possible (and in fact, likely), that a physician seeing a patient for a consultation might have spent 45 minutes and coded a 99244 visit, while the hospital facility charge is based on the nursing time of only 10 minutes and equates to a 99201.
The physician is reimbursed at a lower rate because he is in a facility. The hospital is reimbursed for their costs associated with nursing.
Even if the patient is in a global surgical post-op period for the physician follow-up visit (no charge by MD CPT 99024), the facility still charges for the nursing time and use of any supplies/equipment (e.g. re-casting for fractures).
F Tessa Bartels
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join