![]() Misunderstanding #2: Only “critically ill” patients can receive critical care. However, the hospital can submit a facility charge for critical care. ![]() The surgeon cannot submit a professional charge for critical care.If a trauma surgeon spends only 20 minutes with a patient during an activation but the trauma team as a whole spends 45 minutes providing care: This is where the misunderstanding often comes into play. Remember, the critical care charge discussed here is the facility fee, not the physician’s professional fee. (For more information on this point, read my recent article on trauma charge capture: 5 coding and billing mistakes that reduce trauma center revenue.) In fact, CMS regulations state that critical care time can include care delivered by either physicians or hospital staff. Many billers think this means 30 minutes of physician time. According to the Centers for Medicare & Medicaid Services (CMS), a trauma team must provide at least 30 minutes of critical care in order to bill for a trauma team activation. Misunderstanding #1: Only physician time counts as critical care time. Two reasons trauma centers lose critical care chargesīased on my experience in trauma centers nationwide, there are two common misunderstandings about critical care billing. ![]() ![]() In this article, I identify common misunderstandings about critical care billing, explain why they are wrong, and show how to ensure full capture of critical care charges and optimal trauma center revenue. As a result, many trauma programs fail to capture a significant percentage of critical care charges. Unfortunately, critical care billing is widely misunderstood by both trauma program leaders and hospital finance departments. This paid content was developed by Trauma System News in cooperation with our sponsor. A trauma team must provide at least 30 minutes of critical care before the hospital can bill for a trauma activation, so failure to capture critical care charges will reduce trauma program revenue dramatically. ![]()
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