- Regulatory guidelines for billing are provided by the Center for Medicaid and Medicare Services (CMS). While the guidelines for Medicare are fairly standard across the United States, regulations for Medicaid reimbursement vary widely from state to state. Private insurance companies may have different requirements, as well. The method of billing employed may also be dependent on the type of provider offering the service.
- It is important to use the proper Current Procedural Terminology (CPT) codes to receive reimbursement for services. The CMS recently issued new CPT codes for educational services. Providers across the country have been successfully billing third party payees using these codes.
- The type of service agency must be specified, so the correct CPT code can be assigned. Further, physicians must order asthma education for patients so that it might be a billable service. While a variety of health care providers, like doctors, nurse practitioners, respiratory therapists and social workers, can provide asthma education, they must be certified by the National Asthma Educator Certification Board.
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