Billing: Bilevel versus simple CPAP

[ThadeusJ]

Quick question about billing and reimbursement: is Bilevel different from simple CPAP? I realize the clinical implications and outcomes, but from a logistics persepctive, is there a difference besides cost of equipment? I'm exploring a cost/case examination.

 

[FiremanMike]

I'd be surprised if anyone here knew itemized billing amounts... Your best bet is to reach out to whomever is your liaison with your billing company..

 

[CANMAN]

Alot of billing questions and issues are going to change state to state. For example, in MD CPAP would likely be billed at the ALS2 level. Bilevel, BiPAP, NIV whatever you want to call it is billed at the Critical Care or (SCT) level. Different reimbursement rate for both. Like Fireman said, check with your billing person....

 

[hometownmedic5]

Emergent CPAP is BLS here(Massachusetts), so there’s that.

Non emergent(IFT) CPAP or BiPAP requires the use of the transport ventilator, and that means SCT if it’s been explained to me correctly.

Of course, I’m a truck donkey not a billing wench, so who knows.

 

[NPO]

I'm also going to guess that it would be an SCT item, but to bill for SCT you have to be an SCT provider and provide extra training, not just throw a vent on a truck and call it SCT.

We do a lot of SCT transports but I believe they are billed ALS1 or ALS2 because we probably don't meet the requirements to be considered an SCT provider.

 

[johnrsemt]

When I worked in Indiana we had 4 billing levels: ALS, BLS, Emergent Transport (Lights and Sirens) Non emergent. That's it. plus mileage at $10.95 a mile. No extras. That was 11 years ago so it may have changed.

Here in Utah, and in Nevada where I work now it is crazy we can charge for everything

 

[GMCmedic]

When I worked in Indiana we had 4 billing levels: ALS, BLS, Emergent Transport (Lights and Sirens) Non emergent. That's it. plus mileage at $10.95 a mile. No extras. That was 11 years ago so it may have changed.

Here in Utah, and in Nevada where I work now it is crazy we can charge for everything

Now its BLS, ALS 1, ALS 2, and SCT. Depending on the company, Cpap would gonto ALS 2 or SCT. Bipap would most certainky go to SCT.

 

[NomadicMedic]

Now its BLS, ALS 1, ALS 2, and SCT. Depending on the company, Cpap would gonto ALS 2 or SCT. Bipap would most certainky go to SCT.

CPAP here is BLS or ALS1, depending on what else happened during the call. Obviously, if everything fell apart and the pt required an advanced airway, it would be ALS2