Practice Management

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  • 1.  CAH billing for Radiology PC

    Posted 09-15-2021 17:34

    Is anyone out there familiar with how a Critical Access Hospital would bill for radiologist professional component services?  Specifically, how they would handle remote reads of studies done in their facility.

     

    If you know how this works, I would like to chat with you.

     

    Thanks!

     

    Dave

     

           David Smith, FACMPE  |  Executive Director  |  785.393.8387

    5800 Foxridge Dr.  Ste 240  |  Mission, KS  66202  |  www.uickc.com

    p-uic-horizontal-03a

     

                                                              Member of

     

                             

     



  • 2.  RE: CAH billing for Radiology PC

    Posted 09-16-2021 08:16

    Dave,

     

    For a critical access hospital to bill for the interpretation services of a radiologist, traditional reassignment procedures apply. An 855R is submitted by the CAH for each interpreting physician.

     

    And the Medicare place of service billing guidelines also apply. The remote interpreting radiologists address for the service is denoted by the CAH billing for the reassigned interpretation in Box 32 of the 1500 claim form or electronic equivalent, unless that address for the location of the interpretation is an infrequent our unusual location.

     

    Thomas W. Greeson

    703.517.0495 (cell)

    tgreeson@reedsmith.com

    Pronouns: He/Him/His

     

    Reed Smith LLP

    7900 Tysons One Place

    Suite 500

    McLean, Virginia 22102-5979

    Office Telephone: 703 641 4242

    Facsimile:   703 641 4340

     

     

     

     






  • 3.  RE: CAH billing for Radiology PC

    Posted 09-16-2021 08:23
    Thanks Tom!

    One more question:  Would a CAH be able to bill globally if the read was done onsite or in the same locality, or would the claims always be split?

    Dave

    ------------------------------
    David Smith FACMPE
    Executive Director
    United Imaging Consultants
    Mission KS
    (785) 393-8387
    ------------------------------



  • 4.  RE: CAH billing for Radiology PC

    Posted 09-16-2021 08:31

    Dave,

     

    For traditional Medicare services, they cannot. The PC would be billed separately with the -26 modifier.

     

    Tom

     

    Thomas W. Greeson

    703.517.0495 (cell)

    tgreeson@reedsmith.com

    Pronouns: He/Him/His

     

    Reed Smith LLP

    7900 Tysons One Place

    Suite 500

    McLean, Virginia 22102-5979

    Office Telephone: 703 641 4242

    Facsimile:   703 641 4340