Wiki Injections done in office vs ASC

[SCCL5558]

I have a Pain Management provider that will start doing his injections, ESI, Nerve blocks, RFA's in office rather than at the ASC. He is purchasing a Fluoroscopy machine as well. I'm unfamiliar as to what else we can bill on top of the injections (eg: 64493, 99144)? Are we able to bill for supplies used?

If anyone can provide any help it would be GREATLY appreciated!!

 

[dwaldman]

For Medicare, whether in ASC or office, the typical supplies used to perform these procedures is going to be included in the payment for procedure under the CPT code. Medicare has a site of service differential that accounts for those costs in an office setting. The fee schedule shows in a facility setting versus in an office setting. The extra reimbursement would cover those costs in an office setting. For example, in facility setting the professional payment would be around 94.03, in contrast, in a office setting the reimbursement would be 175.20.

I am not real familiar would ASC versus office payment methodology but it would be important to know if the private payers and Medicaid carriers that you bill also have a site of service differential or how those costs are covered.