Practice Management Alert

Question: Our practice is located in an area with a growing deaf population, which may mean an increase in patients needing translation services. What are we required to do in these circumstances?

New York Subscriber

Answer: Your practice must provide an interpreter when a patient is unable to communicate with your providers because of a disability, such as hearing loss, or because she doesn’t speak English.

The law: Physicians are required to comply with the 1964 Civil Rights Act, as amended; Section 504 of the Rehabilitation Act of 1973; the Age Discrimination Act of 1975; the Omnibus Reconciliation Act of 1981; the Americans with Disabilities Act of 1990; and all other applicable federal and state laws that prohibit discrimination in the delivery of services on the basis of race, color, national origin, age, sex, handicap/disability, or religious beliefs. Therefore, you must provide interpreter services to patients covered by these laws.

The tricky part is that often, payers do not reimburse practices for the cost of interpretation services, so you’ll need to consider this part of the cost of doing business. Check your individual payer policies, keeping in mind that they may not be the same across the board.

Caution: While you may be tempted to try reporting T1013 (Sign language or oral interpretive services, per 15 minutes), this code is not valid for Medicare, according to the Medicare Physician Fee Schedule, which assigns the code status I (Not valid for Medicare purposes). The majority of payers designate T1013 for use only by contracted non-medical vendors; however, some payers may let you bill this code. However, if your provider spends extra time with a patient because the interpretive services extend the visit, you may be able to seek reimbursement for that extra time. You may be able to use a prolonged service code in this situation if the time thresholds for billing both E/M services and the prolonged services code have been met. Documentation must also establish the medical necessity for the service.

Note: Even though you may not be able to bill the insurance company, you cannot pass your practice’s costs for providing an interpreter on to the patient. To help alleviate some of the costs of providing an interpreter, you can consider using someone on staff, if she meets the interpreter guidelines set forth in the laws. In other words, if you know your practice sees several deaf patients, perhaps you should consider sending an employee for sign language training or hiring an employee that already has this skill.