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What is the new Therapy Cap process

by Medical Billing | Apr 20, 2017 | Medicare payment basics

New Therapy Cap Process: Frequently Asked Questions What is the new Therapy Cap process?  Answer: Starting October 1, 2012, claims for patients who meet or exceed $3,700 in therapy expenditures will be subject to prior authorization. For outpatient therapy...

Billing Initial Hospital Care and Discharge – multiple e & m service on Same Day

by Medical Billing | Jun 8, 2016 | Medicare payment basics

QUESTIONS AND ANSWERS 1 Q: If a patient is seen in the office at 3:00 p.m. and admitted to the hospital at 1:00 a.m. the next day, may both the office visit and the initial hospital care be reported? A: Yes. Because different dates are involved, both codes may be...

Initial Hospital Care Visits by Two Different M.D.s or D.O.s When They Are Involved in Same Admission

by Medical Billing | Jun 5, 2016 | Medicare payment basics

In the inpatient hospital setting all physicians (and qualified nonphysician practitioners where permitted) who perform an initial evaluation may bill the initial hospital care codes (99221 – 99223) or nursing facility care codes (99304 – 99306). Contractors consider...

Policy Guideline for provider performed unlisted CPT code

by Medical Billing | May 15, 2016 | Medicare payment basics

Overview Some services or procedures performed by providers might not have specific Current Procedure Codes (CPT) or HCPCS codes. When submitting claims for these services or procedures that are not otherwise specified, unlisted codes are designated. Unlisted codes...

How much payment would get Assitant Surgeon, Co- Surgery and Team surgery

by Medical Billing | Apr 21, 2016 | Medicare payment basics

Assistant Surgeon Services Harvard Pilgrim reimburses assistant surgeon services when the assistant at surgery is a physician, a physician assistant, or a nurse practitioner consistent with CMS’ determination of approved procedure codes payable to an assistant...
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CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). All Rights Reserved to AMA.
The revenue codes and UB-04 codes are the IP of the American Hospital Association. All Rights Reserved to AMA.
All our content are education purpose only. All the articles are getting from various resources. If you find anything not as per policy. Please reach out and we would do the investigation and remove the article.
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