Administrative and Billing Issues for Palliative Care Programs
Financial Procedures for Billing and Tracking
Since a substantial proportion of staff salaries and overhead can be recovered from physician and/or nurse practitioner billing, careful attention must be paid to accurate and comprehensive clinical billing and tracking processes.
Coding and Reimbursement for Services
Accepted billing procedures will vary across states and institutions. Therefore, an essential first step to developing policies and procedures for coding and billing palliative care services is collaboration with hospital billing experts.
Coding for reimbursement almost always requires two parts:
- Procedure/service codes describing the procedures performed by the physician/nurse practitioner (referred to as CPT codes), and
- Diagnosis codes describing the reasons for the physician services (referred to as ICD-9-CM codes).
Go to Billing Tools to view sample tools being used by existing palliative care programs.
CAPC's Guide to Building a Hospital-Based Palliative Care Program provides more detail on the type and use of billing codes for palliative care services.