Medical Billing Forum

Billing => Billing => : Christy January 28, 2014, 03:34:59 PM

: Place of Service Question
: Christy January 28, 2014, 03:34:59 PM
I bill for an LCSW who has been invited to run group therapy at a senior living residence. The residence is mixed- some is assisted living and some is independent living.

The location where the groups would take place is in a common area of the independent living wing.

What would the place of service be? My instinct is that the provider needs to establish with Medicare an office location at this facility.
Would you use “office” as place of service? Nothing else is appropriate.

All input/thoughts appreciated!

Thanks!
: Re: Place of Service Question
: Michele January 28, 2014, 04:41:17 PM
Since the location is in the independent living wing area I would think that the location would be 12 for home.  Although I don't know if insurance carriers will pay that code with a location of 12.  Office would not be appropriate unless provider did establish an office there but the rules on that are clear as well and  I believe the provider has to have space that is specifically for their use only and patients outside of that environment must be accepted as well.  So patients cannot be limited to residents of that facility (only if office space is established).  I would start by calling Medicare to see if the group code is allowed with POS 12 or 13.
: Re: Place of Service Question
: Christy January 28, 2014, 07:50:13 PM
thank you Michele. I value your input! :)