Can I bill CPT code 99211 to Medicare for ancillary staff services provided as part of “PT Clinic” services?
Significantly, separate evaluation and management (E&M) services that are provided by ancillary staff “incident to” a physician may be billable to Medicare and other payers when medically necessary. As with all services, the encounter must be documented in the patient’s medical record according to American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) guidelines. However, it is not appropriate to bill CPT code 99211 simply because a patient is seen in the office as part of a PT Clinic or other anticoagulation management service.
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