julrey
New
Can a facility bill 99152 for conscious sedation or is 99152 only for the physician's professional fee? Any resources would be appreciated. Thanks so much!
Most CPT/HCPCS codes involve a practice expense component beyond just those that are split between a professional and technical component, so facilities do bill those codes for the portion that's eligible for reimbursement. For example, facilities will bill surgical procedure codes for the use of the operating room, even though surgical codes have no PC/TC designation. The only codes that are actually never recognized for billing by the facility are codes that represent a professional component only - such as 93010 (interpretation of EKG) - since there is the entire payment for this code goes toward a physician's professional service.One of my shortcuts is that I look up a CPT code on the Medicare fee schedule, and split the modifiers out. Medicare shows there is no professional component or technical component to this code, which is why I answered the way I did. So I was focused on billing it, not on any other cost reporting. I don't know if this information makes a difference.