Leesburg2
New
The facility I work for is looking into providing a mobile clinic, is there a CPT code (I didn't think so but wanted to check) for a mobile clinic and what POS would you use, and documentation requirements?
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Wiki Billing/Coding a Mobile Clinic
- Thread starter Leesburg2
- Start date
SharonCollachi
Guest
Medicare states:
POS 15 - Mobile Unit. A facility/unit that moves from place-to-place equipped to provide preventive, screening, diagnostic, and/or treatment services. (See “Special Considerations” below.) Paid as non-facility rate.
Special Considerations for Mobile Unit Settings (Code 15): When services are furnished in a mobile unit, they are often provided to serve an entity for which another POS code exists. For example, a mobile unit may be sent to a physician’s office or a skilled nursing facility. If the mobile unit is serving an entity for which another POS code already exists, providers should use the POS code for that entity. However, if the mobile unit is not serving an entity which could be described by an existing POS code, the providers are to use the Mobile Unit POS code 15. Apply the nonfacility rate to payments for services designated as being furnished in POS code 15; apply the appropriate facility or nonfacility rate for the POS code designated when a code other than the mobile unit code is indicated. A physician or practitioner's office, even if mobile, qualifies to serve as a telehealth originating site. Assuming such an office also fulfills the requirement that it be located in either a rural health professional shortage area as defined under section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A)) or in a county that is not included in a Metropolitan Statistical Area as defined in section 1886(d)(2)(D) of the Act, the originating physician's office should use POS code 11 (Office) in order to ensure appropriate payment for services on the list of Medicare Telehealth Services.
POS 15 - Mobile Unit. A facility/unit that moves from place-to-place equipped to provide preventive, screening, diagnostic, and/or treatment services. (See “Special Considerations” below.) Paid as non-facility rate.
Special Considerations for Mobile Unit Settings (Code 15): When services are furnished in a mobile unit, they are often provided to serve an entity for which another POS code exists. For example, a mobile unit may be sent to a physician’s office or a skilled nursing facility. If the mobile unit is serving an entity for which another POS code already exists, providers should use the POS code for that entity. However, if the mobile unit is not serving an entity which could be described by an existing POS code, the providers are to use the Mobile Unit POS code 15. Apply the nonfacility rate to payments for services designated as being furnished in POS code 15; apply the appropriate facility or nonfacility rate for the POS code designated when a code other than the mobile unit code is indicated. A physician or practitioner's office, even if mobile, qualifies to serve as a telehealth originating site. Assuming such an office also fulfills the requirement that it be located in either a rural health professional shortage area as defined under section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A)) or in a county that is not included in a Metropolitan Statistical Area as defined in section 1886(d)(2)(D) of the Act, the originating physician's office should use POS code 11 (Office) in order to ensure appropriate payment for services on the list of Medicare Telehealth Services.
mmnicolas
Contributor
Hi
Thank you fo the information. Additional question, does the mobile unit need its own NPI number? Or can is share the NPI that the unit is extending from. Ex. dental mobile van parked in on the property of the clinic building?
Thank you fo the information. Additional question, does the mobile unit need its own NPI number? Or can is share the NPI that the unit is extending from. Ex. dental mobile van parked in on the property of the clinic building?
SharonCollachi
Guest
Does the dental clinic own the mobile dental van?
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Yes please answer this if the originating site owns everything in the unit and it’s their own expenses doctors and overhead how do you show this on a pos 15 claim when Parker t is registered inpatient
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It seems like applying facility rate of another location when there is a doctor in the clinic we own the clinic and pay all expenses separately from the facility but are in the parking lot we need a way to show that
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The Medicare guideline that says we must use the facility code seems unjust someone chime in here
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Is there a modifier in HCspcs we could use to show that seems like Medicare needs that or a special “hut” designation
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Like a pos 15 ip independent provider designation why’s
Because we are praying for everything the clinic the insurance the equipment etc if pt is I patient I can see 26 modifying the equipment like in a hospital and having a negotiated rate with the facility if they are getting a daily rate
Because we are praying for everything the clinic the insurance the equipment etc if pt is I patient I can see 26 modifying the equipment like in a hospital and having a negotiated rate with the facility if they are getting a daily rate
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maybe give our mobile office its own pos shen this is the case like an pos 98? Mobile office where all overhead is paid by the mobile office but is not telehealth originating site
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How do we get this consideration it is helpful to all insurance companies not to send our nursing home patients and risk them getting admitted to hospital or paying for transport out to the different pos for services that can be offered in parking lot but to underpay due to lack of pos seems weird and throwing baby out with bathwater for patients first but stake holders second
TThivierge
True Blue
Piper
Here is information may help ....claims for Originating Site services may be reported using HCPCS code Q3014 (Telehealth originating site facility fee) on either a professional (CMS-1500) or a facility (UB-04) claim when a Telepresenter is present at an Originating Site location other than the patient's home. Then add documentation of illness, verify patient's demographic, mode is pt is telehealth face to face at mobile site, , add mintues in current notations too. Q3014 is not like using modifier 95 for video or modifier 93 for phone call linked to Eva Mgt codes..
I hope this is A ok
Lady T