JUL 19, 2016
How to Bill for Services Rendered in Procedure Room
Question: We are remodeling our practice and want to add a designated procedure room. Will payers reimburse at a higher rate for procedures performed in our room rather than a facility?
Answer: You will still code the place of service as 11 Office setting. Payers already have a site-of-service differential that allows for higher payment in the office (versus the facility) due to the practice expense. Keep in mind that not all surgical procedures have an allowable in the office setting. When pre-authorizing with the non-Medicare payer, be sure to indicate that this is an office-based surgical procedure.