Help I am a little confused. Information that I am finding is telling me I can bill for this code, but there is no reimbursement for it. The information states that if the physician is not meeting with the patient then the physician can bill CPT code 99090, but why would he if he will not get reimbursed? Thanks for your help.
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About this Question
- Posted by Nancy Smith 1 year ago. There are 5 posts. The latest reply is from .
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Medicare considers 99090 as bundled into other basic service provided during the visit and hence does not cover it separately. While some payers may follow the Medicare guidelines, there is a chance that some payers may reimburse for the service. It is better to clarify with your payer if it is not Medicare.
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I agree with Ash, as per Medicare fee this code is considered as bundled Code it states that "Payment for covered services are always bundled into payment for other services not specified. If RVUs are shown, they are not used for Medicare payment. If these services are covered, payment for them is subsumed by the payment for the services to which they are incident. (An example is a telephone call from a hospital nurse regarding care of a patient)".
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Thank You so much for your answers, but what happens if there is no other services billed that day?
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Still the same rule applies. Analysis of the clinical data stored in the computer is part of the main procedure and when the physician does that does not make any difference.
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