Medicare Compliance & Reimbursement

Question: My physician completed forms relating to the Family and Medical Leave Act for an existing patient who is the mother of twins. The physician filled out the paperwork while the mother and babies were in the office for counseling related to caring for the twins. She needed advice on dealing with double the care and needing more time off from work. Can I bill for the time taken to fill out the forms?

Answer: For the time spent by your physician to fill out the forms, report 99080 (Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form) in addition to the appropriate office visit code (99201-99215, Office or other outpatient visit …).Also consider using 99080 when you complete forms that require more information than you usually provide in a standard report, such as school and sports forms.

Keep in mind: Many payers do not reimburse practices for 99080. You’ll want to check with your local payers.

If your payer won’t recognize 99080 you can choose to bill the patient for the form completion service. The decision is up to your individual practice. Many offices will not charge for the forms if they are brought in at the time of a visit, whereas other offices will charge regardless.

Because Family and Medical Leave Act forms require a lot of work, some practices charge the patient for completing these forms in order to capture some reimbursement for the provider’s time. Letting the patient know this ahead of time could help when trying to collect this fee from her.