What is professional billing?

What is professional billing?

• A. Charging for services performed by physicians or non-physician practitioners (NPPs).
• B. Charging for services done in hospitals and clinics.
• C. Billing only for medication costs.
• D. Billing for administrative tasks.

Answer: (A)

Professional billing is charging for the clinician’s professional services. It covers the work done directly by physicians and non-physician practitioners—think office visits, evaluations, consultations, and procedures performed by the provider. Claims use CPT/HCPCS codes to describe the specific service and any modifiers that reflect complexity or time. This purpose is distinct from facility billing, which bills for the use of hospital or clinic resources and space, and from medication or supply costs, which are billed separately in many cases. Administrative tasks are overhead for running the practice and aren’t the professional services being billed.

Professional billing is charging for the clinician’s professional services. It covers the work done directly by physicians and non-physician practitioners—think office visits, evaluations, consultations, and procedures performed by the provider. Claims use CPT/HCPCS codes to describe the specific service and any modifiers that reflect complexity or time. This purpose is distinct from facility billing, which bills for the use of hospital or clinic resources and space, and from medication or supply costs, which are billed separately in many cases. Administrative tasks are overhead for running the practice and aren’t the professional services being billed.