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tci General Surgery Coding Alert - 2015 Issue 6

Reader Questions: Distinguish Facility vs. Non-Facility Fees

Question: Can you please explain whether we should use the facility global fee or the non-facility global fee if we’re billing for our surgeon’s service for a hospital outpatient? Texas Subscriber Answer: When your surgeon provides a service to a patient as a hospital outpatient, you should bill the facility global fee. You should not use the non-facility global fee, in this case. Here’s why: Medicare pays more for visits that take place in a physician’s private office because you collect additional dollars to reflect the “cost of doing business” in your own practice...

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