Neurology & Pain Management Coding Alert

Question: May we charge for the use of biofeedback machines in the home?

Florida Subscriber

Answer: You should report biofeedback training with 90901 (Biofeedback training by any modality) or 90911 (Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry). After training, the patient should be able to perform the biofeedback correctly in the home. However, national Medicare policy makes no provision for the cost of providing biofeedback machines for home use.

If the biofeedback units are provided free to the neurologist from a hospital or manufacturer, the patient may not be charged. If the neurologist owns or rents the biofeedback unit, he or she may charge the patient by providing an advance beneficiary notice (ABN) explaining that the service is noncovered by Medicare and is therefore the patients responsibility. Some third-party payers will reimburse for the cost of providing biofeedback units, by contractual agreement or via 99199 (Unlisted special service, procedure or report) with preauthorization. In all cases, the neurologist must determine a reasonable charge for using the biofeedback machine.

Note: For more information on the proper use of ABNs, see page 47 of Neurology Coding Alert, June 2001.

To protect themselves from liability or unreasonable repair costs, physicians providing biofeedback units for home use should consult with a medical attorney to create a rental agreement that covers the potential of patient damage to the unit.