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New E&M codes for the year 2019

For 2019, the E&M section of CPT code book will have two new codes for Interprofessional Telephone/Internet/Electronic Health Record...

Examples for P9604


Flat Rate (P9604)

Example 1: A laboratory technician travels from the laboratory to a single Medicare patient’s home and returns to the laboratory without making any other stops. The flat rate would be calculated as follows: 2 x $10.00 for a total trip reimbursement of $20.00, plus the specimen collection fee.

Example 2: A laboratory technician travels from the laboratory to the homes of five patients to draw blood, four of the patients are Medicare patients and one is not. An additional flat rate would be charged to cover the 5 stops and the return trip to the lab (6 x $10.00 = $60.00). Each of the claims submitted would be for $12.00 ($60.00/5 = $12.00). Since one of the patients is non-Medicare, four claims would be submitted for $12.00 each, plus the specimen collection fee for each.

Example 3: A laboratory technician travels from a laboratory to a nursing home and draws blood from 5 patients and returns to the laboratory. Four of the patients are on Medicare and one is not. The $10.00 flat rate is multiplied by two to cover the return trip to the laboratory (2 x $10.00 = $20.00) and then divided by five (1/5 of $20.00 = $4.00). Since one of the patients is non-Medicare, four claims would be submitted for $4.00 each, plus the specimen collection fee.

Also see P9603

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