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OBGYN and a Primary Care Provider

Rodney Posted Fri 15th of June, 2018 16:11:48 PM
Can a an obgyn - bill G0444 and G0442 for a Medicare patient, when the obgyn acts as their primary care provider?
SuperCoder Answered Mon 18th of June, 2018 07:17:58 AM

Medicare policies cover one screening session of annual alcohol misuse screening, 15 minute session. Medicare does not cover this service, however, when provided by a psychiatrist. CMS will generally allow coverage for G0442, Brief face–to–face behavioral counseling for alcohol misuse, 15 minutes only when the following provider specialties, who are on the provider's enrollment record, submit the services: General Practice, Family Practice, Internal Medicine, Obstetrics and Gynecology, Pediatric Medicine, Geriatric Medicine, Certified Nurse Midwife, Nurse Practitioner, Certified Clinical Nurse Specialist, and Physician Assistant.

Medicare covers G0442 once every 12 months. Code G0442 must be billed first in order for subsequent claims for G0443 to be covered.

In the code G0444, provider reports this code when she screens a patient for the presence of depression. The provider (Obs Gyn) offering the service should be an authorized clinician. The patient receives the service in a primary care setting, outpatient hospital, independent clinic, state or local and rural health clinic.


And your OB-GYN can be Provide of Primary Care, for example— a yeast infection, say, or a positive at-home pregnancy test—there’s no question you should call on your obstetrician/gynecologist (OBGYN) for care. But what if you have a nasty cough, or need a flu shot, if you are like many women, you will also turn to your Ob Gyn. In fact, it shows nearly half of all Ob Gyns consider themselves primary care physicians (PCP). Generally, if you don’t have any major medical problems, you may be all right visiting your Ob-Gyn as your regular doctor.

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