julieordway
Networker
When billing for a category III code that does not have an RVU, what is the reimbursement process? Do I reach out to the payer prior to providing the service and establish a payment fee?
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Wiki Billing for Category III code
- Thread starter julieordway
- Start date
TThivierge
True Blue
Hi Julie
I d got to the CMS phys fee list put CPT code in there should give you an estimate fee for procedure plus tell you the dx code slinked to it . You can contact payer after that but most go by CMS Medicare phys fee list online web site
Lady T
I d got to the CMS phys fee list put CPT code in there should give you an estimate fee for procedure plus tell you the dx code slinked to it . You can contact payer after that but most go by CMS Medicare phys fee list online web site
Lady T
Category III codes aren't always reimbursable. It's a case by case basis and by payer. Basically these codes have been created to establish usage so that in the future a category I code might be created. Reach out to the payer to see if they reimburse the code.