Following is the breakdown of how in-office treatment with our device is successfully billed in California (Medicare).
It is important to note that this model not only allows for in-office treatment coverage (at least 11 visits total), but allows the clinic / physician to provide the patient with a free loaner device for use at home after completing the series of in-office treatments. In effect, the series of in-office billings more than covers the wholesale purchase of the device by the clinic / physician, allowing the pass-along of the device to the patient following the in-office treatments:
Initial Office Visit (assessment)
Code: 99215 (office visit for established patient)
Visit purpose: assessment, patient education, provision of symptom tracking / self-assessment paperwork to patient (to track sleep quality, etc). No stimulation treatment in this visit.
Office Visits for Treatment - batched in 3 sessions, typically Monday, Wednesday, Friday
Codes: 99213 or 99214 (office visit) plus two billings of 97032GP (electrical stimulation, manual, 15 min) to cover the 20 minute treatment (and set up and break down)
Visit purpose: Practitioner records patient symptom status since last visit, sets patient up with device who uses device for 20 minute treatment session (no supervision necessary during the 20 minutes), followed by practitioner retrieving device.
Visit purpose: assess if patient has experienced improvement over the duration of treatment (referencing self-assessment documentation), practitioner then provides patient with a loaner device for patient to use at home, with instructions. The loaner device does not need to be returned to clinic - the clinic has already covered the cost of the device via the revenue from 11+ total visits.
Patient is now able to use the device on a daily basis at home, with a free loaner device, and the clinic / physician has been fairly compensated (the device purchase is essentially covered by the overhead billing)