billing question

[jonnyboy]

does anyone understand the medicare fee schedule? on the fee schedule, it lists 2 columns, "office pay" and "facility pay". when you submit a bill for reimbursement, is the amount received only the "office pay" or only the "facility pay", or is it the two combined together? what is "office pay" and what is "facility pay?

for example:
for an established level 3 pt visit is the reimbursement $53, or $53 + $35 = $88?
intravitreal injection is it $200 alone for everything, or is $200 + $150 = $350?

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[f_w]

The 'office' fee is the one you bill is if you do the procedure in your own office and includes all supplies and use of your office.

The facility charge is the charge you as a physician bill if you do a procedure at a hospital or ASC (the facility charges the patient separately for OR usage and supplies).

 

[jonnyboy]

thanks