Wiki Can you charge for a consultation prior to doing an IOVERA treatment, if the patient was referred from another provider?

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miyo

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We refer out to another provider for IOVERA, and I was asked if that provider can charge for a consult prior to providing the IOVERA treatment.
We can’t find anything that states you can or that you cannot. Appreciate any information.
 
Hi there, this doesn't look like a consult. It looks like a straight-forward referral to another provider, who assumed care of the patient for the condition that required the cryoablation service. There are three parts to a consult, starting with a request for a consult from the referring practice. But of course it must also be medically necessary.
 
miyo said:
This provider is new to providing this service, he’s been only charging for the procedure.
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That would be correct. Remember - Medicare and most private payers have stopped paying consults because there was so much improper coding. If the provider is billing a payer that still covers consults he should review their policy very closely.
 
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