Medical Billing Forum

Billing => Billing => Topic started by: Anne on October 22, 2008, 01:31:10 PM

Title: 97802 and 97803
Post by: Anne on October 22, 2008, 01:31:10 PM
I've been asked by a clinical dietitian if I would be interested in billing for her.  This would be a new specialty for me.  This provider wants to know how much she'll be reimbursed by Medicaid for 97802 and 97803.  I've been reading all morning in the Medicaid website and the reimbursement fee sched. is unclear to me.  I bill for PT and OT and there's a Medicaid reimbursement for all codes, but for dietitians, it says $17.18 RVU (relative value unit) for 15 min increments, and $28.64 is a conversion factor amt.  It explains in the website what the RVU is, but I do not understand it exactly.  How do I know how much she'll be reimbursed?  Also, it's not clear to me how many units she can charge for - it seems very limited.   Does anyone out there bill for dietitians?  Some patients are on Medicaid and some have primary ins. and Medcaid secondary.
Title: Re: 97802 and 97803
Post by: Michele on October 22, 2008, 09:11:47 PM
I haven't billed for any dietitians, but I am familiar with the 97802 & 97803 codes.   

I would contact Medicaid and ask them to explain how they calculate payment based on the RVU and conversion factors.  They should be able to explain it to you. 

Hopefully someone else on the forum has had experience with dietitian billing and will respond as well.   8)
Title: Re: 97802 and 97803
Post by: Anne on October 23, 2008, 04:46:20 PM
thank you, I did talk to provider rep yesterday.  Looks like reimbursement for a dietitian is very low for Medicaid patients.  I'm thinking of not taking this on.  I hate to turn down new business but don't think I'm set up for this type of billing.  High volume, but low reimbursement. 
Title: Re: 97802 and 97803
Post by: Michele on October 23, 2008, 09:12:48 PM
That's a tough one.  I understand completely.  You must weigh the information carefully, but if you aren't going to make something then you can't afford to spend the time.  Especially if you are just getting going.

Good luck with your decision.