General Category > General Questions

Basic Physician Billing Question

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Patricia Moore:
We are a hospital. The Dr. bill for his services and hospital for use of facility. Dr. get paid and hospital charges on Ub04 are denied. The denials are usually, "duplicate".

PMRNC:
Ah ok, because why would the carrier pay for therapy in a hospital setting and then turn around and pay for facility? Pretty sure that your not going to get both fees, only the professional component.

QueenAlicia:
Isn't 90806 for a mental health or psychology practice?  One of my providers is a psychologists and that is what we bill often.

Michele:
YOu can bill the 90806 on a UB04 but you have to have the corresponding rev code as well.  But I do doubt both will be paid.  The 90806 allows for the "facility".  Unless they reduced the allowance for the professional fee based on the place of service.

PMRNC:

--- Quote ---But I do doubt both will be paid.  The 90806 allows for the "facility".  Unless they reduced the allowance for the professional fee based on the place of service.
--- End quote ---

I have to ask.. what facility would charge a facility fee for psychotherapy?? I could see if therapy was part of an inpatient stay but not outpatient with facility charge, even your high end rehab centers where you go don't charge both!

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