lfreeman71590
VA / MD / DC Centering Network
Posts: 3
I work at a: Healthcare Facility
My job role is: Staff
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Post by lfreeman71590 on Oct 18, 2018 14:41:46 GMT -5
Our practice is looking into the possibility of starting Centering. The providers would oversee the program with our Mid-Wives actually providing the service. We were wondering how we would bill this (as we are looking to use a room in a local hospital, not our own facility as we don't have the room in our office to accommodate such a large group), what CPT and ICD10 codes we would use, what place of service code this would be, and if there's a reimbursement guide on these services for Virginia? I've seen the locked thread in the FAQ stating that these visits are billed as normal prenatal visits, however this was last updated in 2016 and I know how quickly things can change.
Any help you can give would be appreciated.
Thanks!
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Post by Tanya Munroe on Oct 18, 2018 15:03:20 GMT -5
Our practice is looking into the possibility of starting Centering. The providers would oversee the program with our Mid-Wives actually providing the service. We were wondering how we would bill this (as we are looking to use a room in a local hospital, not our own facility as we don't have the room in our office to accommodate such a large group), what CPT and ICD10 codes we would use, what place of service code this would be, and if there's a reimbursement guide on these services for Virginia? I've seen the locked thread in the FAQ stating that these visits are billed as normal prenatal visits, however this was last updated in 2016 and I know how quickly things can change. Any help you can give would be appreciated. Thanks! There may be some info here already that will be helpful! Check out these threads: centeringconnects.org/threads/recent?q=billing+coding This one may be particularly helpful: centeringconnects.org/thread/252/billing-codes-centeringCentering sessions are still billed as a regular prenatal visits in the vast majority of practices. Feel free to keep the questions coming, we're glad you're thinking about starting! |
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lfreeman71590
VA / MD / DC Centering Network
Posts: 3
I work at a: Healthcare Facility
My job role is: Staff
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Post by lfreeman71590 on Oct 18, 2018 15:18:32 GMT -5
Hi!
Thank you for your reply! I've reviewed the linked threads and none of them have our particular state or situation (also a lot of the outside links included in those threads I'm finding have been removed) .
We're actually looking to use a facility that's not ours as our practice is not large enough to host a large group of people. We plan on using a room (something similar to a conference room) in a local hospital. I'm not sure if this would change how these visits are billed. I know at least the place of service would change but I'm not sure what exactly we'd use. I'm trying to find some written documentation I can show to administrators so we can get this approved for our practice regarding reimbursement as well.
Thanks again for your swift reply!
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Deleted
Deleted Member
Posts: 0
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Post by Deleted on Oct 19, 2018 8:59:04 GMT -5
While I can't speak to Virginia since I support practices in other states, I have worked with a few that used space outside their own clinic for their Centering groups. Let me reach out to them and see if they can share their experiences on here. I am fairly sure there have not been billing issues! Just a warning that we have had a couple of practices be denied space in their affiliated hospital due to Stark Law, a set of laws that prevent physicians from self-referral for profit. I still haven't quite wrapped my head around how providing the space would be a violation, but hospital administrators have been pretty unambiguous about this. The practices have been able to either rent a room in a location unrelated to either organization or use space belonging to a non-healthcare community organization. See this thread for a bit of background centeringconnects.org/thread/1256/stark-law I bring this up just because in at least one of those cases, the plans to use the hospital space had proceeded quite far before an upper-level administrator intervened with the Stark Law concerns, so I want you to be prepared in case it could potentially derail your plans unexpectedly! |
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Post by John Craine on Oct 21, 2018 15:13:36 GMT -5
To the best of my knowledge, Starks Law only prevents donation of space. So long as the practice is paying the hospital a market rate to rent the space, Starks Law doesn't come into play.
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lfreeman71590
VA / MD / DC Centering Network
Posts: 3
I work at a: Healthcare Facility
My job role is: Staff
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Post by lfreeman71590 on Oct 30, 2018 13:03:13 GMT -5
While I can't speak to Virginia since I support practices in other states, I have worked with a few that used space outside their own clinic for their Centering groups. Let me reach out to them and see if they can share their experiences on here. I am fairly sure there have not been billing issues! Just a warning that we have had a couple of practices be denied space in their affiliated hospital due to Stark Law, a set of laws that prevent physicians from self-referral for profit. I still haven't quite wrapped my head around how providing the space would be a violation, but hospital administrators have been pretty unambiguous about this. The practices have been able to either rent a room in a location unrelated to either organization or use space belonging to a non-healthcare community organization. See this thread for a bit of background centeringconnects.org/thread/1256/stark-law I bring this up just because in at least one of those cases, the plans to use the hospital space had proceeded quite far before an upper-level administrator intervened with the Stark Law concerns, so I want you to be prepared in case it could potentially derail your plans unexpectedly! Hi! Have you heard back from anyone on their experiences? Thanks! |
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