Billing Case Management

May 1, 2008

If three providers within the same practice have a conference to discuss a patient and can qualify for a case management charge, who gets to charge - the provider who instigated the conference or all three providers involved in the discussion?

Question: If three providers within the same practice have a conference to discuss a patient and can qualify for a case management charge, who gets to charge - the provider who instigated the conference or all three providers involved in the discussion?

Answer: The physician whose patient is being discussed usually bills the charge and keeps the revenue. You certainly can’t bill it three times.

If all your physicians do case management on a roughly equal basis, there is no problem. They all get some.