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Controversies in Billing for Clinical Services - American Society of ...

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Bill<strong>in</strong>g <strong>in</strong> Physician Cl<strong>in</strong>ics<br />

Bill <strong>for</strong> pr<strong>of</strong>essional fees only and not<br />

facility fees<br />

– Different than pro fees <strong>for</strong> hospitals<br />

Can only bill Medicare under the “<strong>in</strong>cident-<br />

to” criteria and at the lowest CPT level<br />

(99211)<br />

Other payors may be billed at higher levels<br />

but may not pay at this rate

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