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Click here for more sample CPC practice exam questions and answers with full rationale

Billing for managed care services

Our clinic’s case management team routinely goes to visit patients and their families in SNFs to come up with a care plan. The head of managed care would like to start billing for this and I’m looking for a CPT code that this would fall under. The closest I’m seeing is 99366. Does "nonphysician qualified health care professional" mean an actual provider who’s just not a physician? Or would a case manager count? The requirement for a separate E/M could be met with 99490 and it’s very possible that some of these visits include a multidisciplinary team (I’d have to check to know for sure). If so, the requirements would all be met. But when I read about the code online, I get the impression that it’s for nonphysician provider time only. Does anyone know for sure? Or is there a different code you guys use for this? Thanks for any input!

Medical Billing and Coding Forum