Q: Can I code, and be reimbursed for telephone calls with patients?
A: You can code telephone calls (CPT codes 99371-99373) but most fee-for-service
third-party payers will not pay a bill for these codes. Under fee-for-service
reimbursement, a face-to-face visit is necessary. However, if the
patient is covered by a capitated rate; i.e. the practice receives a set fee
per month for the care of the patient, then telephone calls are being
reimbursed under that fee. In a capitated payment system, telephone calls are
more cost-efficient to a practice than an office visit.
Q: Can I cover the time spent on my telephone calls by upcoding the next
office visit with that patient, based on what I did in the telephone call?
A: No, not legally.
This tip is excerpted from The Green Sheet, a newsletter on compensation and
reimbursement for nurse practitioners, published monthly by the Law Office of
Subscriptions: $25 per year (12 issues), mailed first class. To receive The
Green Sheet every month, mail your name, address and a check for $25 to Law
Offices of Carolyn Buppert, 1419 Forest Drive, Suite 205, Annapolis, MD 21403.
A companion newsletter, The Gold Sheet, addresses malpractice avoidance and
quality for NPs. The Gold Sheet is also $25 per year.
Next month: "How to bill for hospital services," covered in the March Green