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The Same Day/Same Service Policy addresses those instances when a single code should be reported by a physician(s) or other qualified health care professional(s) for multiple medical and/or Evaluation and Management (E/M) services for a patient on a single date of service.
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… except where specifically noted, the Medicare Administrative Contractors (MACs) may not pay two E/M office visits billed by a physician (or physician of the same specialty from the same group practice) for the same beneficiary on the same day unless the physician documents that the visits were for unrelated problems in the office, off campus-outpatient hospital, or on campus-outpatient hospital setting which could not be provided during the same encounter (e.g., office visit for blood ...
You normally will not report a separate, same-day E&M service if the provider sees a patient for a previously scheduled procedure or service. Per the Medicare Claims Processing Manual (Chapter 12, Section 40.1), "Visits by the same physician on the same day as a minor surgery or endoscopy are included in the payment for the procedure, unless a significant, separately identifiable service is also performed."
Insurers pay for any medical service based on medical necessity. If the physicians in your program or group routinely see patients twice a day, medical necessity could be called into question. Medicare views providers of the same specialty in the same group as one physician, and it pays for hospital visits on a “per-diem” basis.
Both Initial Hospital Care (CPT codes 99221 – 99223) and Subsequent Hospital Care codes are “per diem” services and may be reported only once per day by the same physician or physicians of the same specialty from the same group practice. Physicians and qualified nonphysician...