Respiratory Physicians

Can we charge sleep study equipment hire fees to patients when we bulk bill their sleep studies?

5 October 24

This questioner said that every time they called Medicare about this, they received different advice and were concerned they may be billing incorrectly. The setting was outpatient sleep studies which are bulk billed by the respiratory and sleep physicians using item 12250. The company (described as an external provider) supplies the patients with the sleep study devices and charges them a hire fee for the equipment. Is this allowed?

Can a specialist bill a 91836 as their first billing in a private practice setting?

4 October 24

The specialist had received a referral from another respiratory physician to perform a bronchoscopy on a patient. The specialist called the patient to discuss the procedure, make them aware of the risks and what could be done as part of the procedure i.e. a biopsy. The patient was given the opportunity to ask any questions they had about the procedure and the costs were explained. The phone consultation was documented in the patient’s record. No previous billings for the patient with the referral have been made yet

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