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Medical Team Conferences

Shelly Posted Tue 15th of November, 2016 14:36:02 PM
I am trying to make heads or tails of Medical Team Conference billing, and I am finding the guidelines confusing. I'm in an ENT practice. Two of our ENT Md's, and 1 of our Physican Asst's will be seeing the pt. We also have other providers (not ENT & not part of our practice) that will be seeing the pt at the same time. Pt will be present for all concerned. It appears that only 1 person from our practice/specialty can bill for their svc, and that would be a standard E&M. Correct? Also, is the Physician Asst considered a "non physician qualified health care professional" in this case? CPT 99367 specifically states "...participation by physician" Does the PA qualify as a "physician" in this case, or a "nonphysician". The CPT guidelines give examples of non-Physicians, but PA's aren't listed, so I'm confused how CPT see's them. Any help or clarification would be appreciated.
SuperCoder Answered Wed 16th of November, 2016 06:52:18 AM

Hi Shelly,

Before concluding we will consider some points mentioned below:

  • Both of these professions (non-Physicians and Physician Assistant) are somewhat similar, with only subtle differences between them. A physician assistant is a medical professional who practice under the supervision of a physician. Because physician assistants have to work in sync with a qualified physician, the number of hours they work is more closely related to that of their supervising physician. However, non-physician like physical therapists or nurse practioner can work independently.
  • All medical professionals participating on the medical team conference billingmust document their own individual participation in the team conference, in addition to their contributed information and follow-up treatment recommendations. However, only one individual from the same specialty may report a code from this category at the same encounter.
  • So seeing above scenarios, PA will not  qualify as a "physician" in this case because number of hours they work is more closely related to that of their supervising physician. Hope it helps. Please feel free to ask if further assistence required.


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