Physician Regulatory Issues Team (PRIT)
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Content Section
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Details for Billing for Medication Management Services
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Shown below are the details for the item you selected from the list.
| Issue Name |
Billing for Medication Management Services |
| Issue |
When medication management services (such as anticoagulation therapy management services) are furnished to an outpatient in a hospital outpatient clinic on the same date that the patient's medication level is tested, may a hospital bill a low-level clinic visit (CPT code 99211) in addition to the CPT code for the laboratory test? |
| Status |
When face-to-face medication management is provided by qualified hospital staff on the same date of the laboratory test to an outpatient in a hospital outpatient clinic, a hospital may bill CPT 99211 if the services are medically necessary and constitute a distinct, separately identifiable E/M service that is consistent with the hospital's criteria for a low-level clinic visit. |
| Date Issue Created |
01/01/2003 |
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Last Modified Date : 05/10/2006
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