Remember these tips for billing for clinic evaluation and management services

BCBSM covers services provided in hospital outpatient clinics. Please remember that clinic evaluation and management services are considered services that only physicians can provide and that can only be billed on a professional claim.

As of April 1, 2013, these services should be billed as outlined below:

• The 24 evaluation and management HCPCS codes previously communicated in the December 2012 issue of The Record must be billed on a professional claim and the professional group or individual practice PIN should be reported on the claim.
• BCBSM recognizes that other services may be provided in the hospital outpatient clinics by non-physician personnel. Those services can continue to be billed on a facility claim.

It is important to note that some groups do not pay for any services billed with the 051X revenue codes.