Can a physician bill for supplies or materials used in the office?

For the most part, supplies and materials are typically bundled with the service/procedure and are not payable separately. According to the AMA CPT guidelines, there are specific codes used to bill for supplies and materials.

They are as follows: 95144–95170: Antigens provided 99070: Supplies and materials (except spectacles), such as sterile trays drugs, cast or strap materials, provided by the physician that are over and above those included with the office visit or procedure. Medicare does not reimburse this code rather the appropriate HCPCS code must be used. 99071: Educational supplies, such as books, tapes and pamphlets provided by the physician for the patient’s education at a cost to the physician. Check with your private payers, as some of them may or may not accept these codes and require use of HCPCS codes. If you routinely dispense a certain supply, it is recommended you contact your payers and determine their coding requirements as some of them, in addition to the CPT code, may require you to list the specific supply on claim submitted.

Ambulatory Surgery Center Billing Tip

Do you know if your ASC is losing money or making money on supplies?

When you buy a specific supply, such as surgical implants for spine or knees, make sure you assign and price it accordingly before it is submitted. Many times, the vendor will change the invoice price without prior notification, be sure to cross reference the price paid and the reimbursement received.