Crystal's MCW Coder Hub🏥 Inpatient Professional Fee Overview
Tags: inpatient profee overview
❤️🩹Definition
Professional Fee (ProFee) coding refers to physician services billed on the CMS-1500 form (or electronic equivalent) for care provided in hospital/inpatient settings.
⚕️ Key Distinctions
| Setting | Billing Entity | Form |
|---|---|---|
| Professional | Physician/Provider | CMS-1500 (837P) |
| Facility | Hospital | UB-04 (837I) |
😷Inpatient ProFee Scope
- Initial hospital care
- Subsequent hospital visits
- Critical care services
- Consultations
- Discharge services
- Prolonged services
👩🏾⚕️Provider Types
- Attending Physician: Primary managing provider
- Consulting Physician: Provides specialty input
- Hospitalist: Manages inpatient care
- Intensivist: Manages ICU/critical care
- Surgeon: Pre/post-op management
Global Period
Surgical procedures have a global period (0, 10, or 90 days). E/M services during global period may require modifiers.
00 Inpatient ProFee Coding MOC Place of Service for Inpatient