tci Medicare Compliance & Reimbursement - 2014 Issue 24

Reader Question: Know the Rules for Multiple Critical Care Doctors

Question: Recently, our facility admitted an established heart patient with acute respiratory failure. The patient was attended to by two physicians during the stay, a pulmonologist and cardiologist, in critical care settings. Can both the physicians bill for critical care separately? On the second day, due to the unavailability of the attending pulmonologist, another physician of the same specialty attended to the patient. Can he bill separately for the visit? Answer: For your first question, yes. More than one physician can provide critical care on the same day and be paid, provided that the following conditions are met: the...

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