# Facility billing for office visit????



## mfranks (Jun 27, 2013)

One of the orthopedic Physicians that I work for is wanting to know if his office can bill both a Facility and professional charge for patient visits. I have never heard of a physicians office billing for both and can not find anything online that gives any advice. Anybody know if this can be done? In my opinion it shouldn't be.


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## mitchellde (Jun 27, 2013)

when the physician office bills the visit with the POS of 11, then the reimbursement will contain booth the professional as well as the facility component.  When you have a visit in the outpatient facility setting then you use the 22 POS and the provider is paid the professional component and the facility is paid the facility component.


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## nyyankees (Jun 28, 2013)

mitchellde said:


> when the physician office bills the visit with the POS of 11, then the reimbursement will contain booth the professional as well as the facility component.  When you have a visit in the outpatient facility setting then you use the 22 POS and the provider is paid the professional component and the facility is paid the facility component.



I would assume that Article 28 practices are billed out as POS 22 which in turn allows both portions of the E/M to be billed?


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## mitchellde (Jun 28, 2013)

Yes but the facility should bill the facility component on a ub and using the facility tool to assess the level of E&M.  The facility E&M is never assessed using physician guidelines


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## Monika Liddle (Jun 28, 2013)

*Facility/Office Billing*

In order for an office to bill both the facility/office charge the office must get credentialed as a Provider Based Facility. You will need to look at the Federal Register to get the criteria that must be met. 

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/a03030.pdf


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