Billing Related to Physician’s Services

80 - Billing Related to Physician’s Services (Rev. 2245, Issued: 06-16-11, Effective: 08-01-11, Implementation: 08-01-11) Normally physicians are responsible for billing for their own services. The services of facility-based physicians (e.g., those on a salary or percentage arrangement, lessors of departments, etc., whether or not they bill patients directly) include two distinct elements - the professional component and the provider component. The professional component of facility-based physicians’ services includes services directly related to the medical care of the individual patient. SNFs cannot bill for the professional components of physician services, these must be billed under a physician provider number to the A/B MAC (B). The technical component (e.g. the component representing the performance of the diagnostic procedure itself) of physician services delivered to SNF inpatients are bundled into the Part A PPS payment and not paid separately. A - Podiatry Services Covered professional services rendered by facility-based podiatrists to individual patients are covered only as physicians’ services under Part B. Note that certain foot care services are excluded under both Part A and Part B. Payments to podiatrists for noncovered services are not allowable Medicare costs regardless of whether the podiatrist’s professional services are covered under Part B.