Ob-Gyn Coding Alert

Question: We are supplying physician coverage twice a month at a facility in another town. We will be using their facility but supplying our own nurses, speculums, lab, and billing supplies. The other location is proposing charging a facility fee to the patient. How does this effect our charges, especially in the case of an ob patient who receives a global fee once the baby is delivered? What code would be used for the facility fee? What place of service code would we need to use on our gyn patients?

Shari Johnson, Clinic Administrator
The Womens Ctr. of Western NE, Scottsbluff, NE

Answer: Facility fees are not reimbursed by third-party payers, except to those facilities that are approved ambulatory surgical centers. There are no CPT codes for facility fees and the use of the facility is built into the payment. Here it sounds more like you should pay the facility fee as you appear to be renting space, or if this is a case of your practice helping to provide coverage, the host should be grateful for the coverage and consider it part of the deal for coverage. If the host insists on charging a facility fee, they should seek reimbursement directly from the patient.