tci Part B Insider - 2008 Issue 29

Reader Question: No Patient Present? Don't Expect Payment From Medicare

CMS' face-to-face E/M billing requirement could nip payment in the bud when you meet with a patient's familyQuestion: Should we bill an office visit (99211-99215) for a consult with a family member to discuss a patient's condition if the patient is not present? Answer:You probably cannot collect reimbursement from Medi-care for discussions with a family member about a patient's condition if the patient is not present during the session.Medicare requirements specify that the physician must meet face-to-face with the patient to report an established patient E/M visit (99211-99215).The only exception to this rule is if the physician...

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