Billing for a patient seen outside of the office????

[Marianna822]

Hello everyone!

I have a question. I can not find a CPT to bill and at this point not sure if I can bill the visit out. Provider sees the patient at her place of employment , which is at an assisted living facility. I don't believe 99214 for office visit is correct and 99336 I don't think works either since the patient is not a resident but an employee of the ALF. Can the provider continue to see her there and bill for the visit even though it is not in our office? ( The provider sees and treats the resident patients at the ALF weekly.) Can anyone help me with this situation?

 

[rthomas@impcna.com]

I am assuming the residents have Medicare and your provider has been approved/credentialed to provide services at the ALF, otherwise he wouldn't be getting paid. I believe that the assisted living facility would need to be added as place of service with the insurance carrier that the employee had. You may want to look into your contract with that insurance. At one time our providers were looking into providing in person services for teachers at our local school and when we contacted their insurance plan they told us that we needed to add the school as one of our locations.

 

[Marianna822]

I am assuming the residents have Medicare and your provider has been approved/credentialed to provide services at the ALF, otherwise he wouldn't be getting paid. I believe that the assisted living facility would need to be added as place of service with the insurance carrier that the employee had. You may want to look into your contract with that insurance. At one time our providers were looking into providing in person services for teachers at our local school and when we contacted their insurance plan they told us that we needed to add the school as one of our locations.

Thank you, I will look into that.