Description
The line between facility and professional (profee) coding is clear — in theory — but in practice, it’s one of the most common areas of confusion in healthcare billing. Knowing who is billing, what services are being billed, and how they’re being reported can significantly impact reimbursement, documentation accuracy, and audit risk. This webinar will provide a clear, practical breakdown of the key differences between facility and professional coding, including how each is billed and documented. We’ll address common pain points such as E/M leveling criteria, source documentation, modifier usage, and the differences between UB-04 and CMS-1500 claim forms.
Objectives:
- Differentiate between facility and professional coding in terms of purpose, billing forms, and coding methodologies
- Identify the types of services and components billed under each coding model
- Define documentation requirements and describe coding responsibilities for both facility and professional (profee) claims
- Recognize common scenarios involving dual billing (e.g., hospital outpatient visits and ED encounters)
- Apply correct use of modifiers such as -26 (professional component) and -TC (technical component)
View webinar Q&A: https://www.thehaugengroup.com/facility-vs-profee-a-tale-of-two-claims/
Appreciated that you ladies gave multiple examples/scenarios AND walked through how you arrived at the codes you did. Helped to see the processes of facility vs profee coding
Great presentation!
Excellent presentation
Good info
It was a little long.
Knowing the difference between UB04 vs CMS 1500
I enjoyed this webinar and thought it was informative
I found a new source of continuing education
Leveling E/M visits include many guidelines
Good and knowledgeable
The main concept between facility coding and inpatient, as I only have inpatient experience.
Great to have a refresher on the point system vs ACEP.
I knew absolutely nothing about the facility side. I now have some fundamentals.
billing and coding req facility vs professional and how pymt is determined
perfect
How to better explain the differences between facility and professional billing
Side by side comparison of PROFEE and Facility were presented in such a great way. Visually and practically with case studies
Was well presented have no suggestions at this time.
NA
It was great!
good information. A great refresher, so many differences.
The difference between Facility and profee coding
great
I liked the detail they went into discussing the topic.,
Everything was clear, concise, and informative. I like how it made it easier to tell the difference between facility and profee and what types of are considered under these
I liked it. Very informative, great pace
It’s educative
I have been a hospital coder for a very long time. For the past couple of years, I have been exposed to the physician side of coding. I always thought coding is coding. True to some extent, but very different rules and thought processes. I really enjoyed the side by side comparison of the two different sides, as it showed the differences in a way that made sense to me.
PB coding is done only from the document that was written for that E/M and only with diagnoses addressed. HB coding is done from all the physician documentation of the entire stay.
Thank you! This was very informative and was free!
Good
none
There was something about this one that made me feel like I was back in elementary school.
great speakers
I was extremely satisfied with the webinar. Learned more common scenarios involving dual billing
It was short and easy to understand.
I now understand more about the difference in facility vs office billing and how these are determined
Really understand how the billing is done now for facility and profee
I loved how they went through the entire presentation explaining how each coding system works and showed the patient’s notes as well. It was very informative. Thank you for allowing me to view it for free.
Very informative.
all good info
I think you should consider doing some classes to further explain concepts and answer any questions. There is a lot of information to be taken from these webinars but its absolutely good! Thank you!
The presenters did a wonderful job of presenting! I learned the difference between a facility bill UB and a professional bill 1500
I code professional side, it was very interesting to learn about the different ways that the facility codes the charges.
Great webinar! I found the information on billing differences of pro fee to facility to be valuable since I am not on the pro fee side
it was too much back and forth, would be easier to understand if it was only professional or facility. maybe do all examples for one first and then the other.
I really love this topic on this webinar. Very clear n helpful for my understanding
This was a very informative webinar and I look forward to seeing more of your webinars.
The webinars are so informative and presented in a way that is easy to grasp. I like the Pro leveling tool that you had. So much better than what I use.
It was helpful to see how the facility and the physician bill differently and what resources are used to help them level their encounters.
I think it was great. Keep up the good work.
Nice work
I took away some things from the facility side such as how you reach level for billing.
It was a good refresher. I really appreciated all of the example situations. It helped confirm I do know what I’m doing and I’m on par for coding knowledge in the profee/facility fee!
The mash up between the facility & profee arrangement is fantastic. It is helpful to learn and understand both sides.
As a facility coder, I was very interested in understanding the components of the profee side. Our organization supplies both facility and profee coding and my goal is to understand both aspects so that two people don’t need to touch an account.
Very organized. Good job.
I learned the difference between facility and profee
Great information
I often get confused between the guidance given in Coding Clinic as they do not specifically say the advice given is for Pro Fee or Facility. This helped to clarify some of the differences for me. ,I find Coding Clinic advice difficult to follow as it is seldom disclosed as to whether the advice is for ProFee or Facility coding. This webinar helped me decipher some of that confusion.
It seemed as if some of the information in the beginning of the presentation was geared towards student coders. Presenters did a nice job of presenting information
Very informative
Great examples
thank you for the information. very helpful.
Lots of info in this webinar, it was a great overall course that provided me with the appropriate information for further digging into how the two different claims can be billed.
I thank you so much for this presentation, it was presented very well. I feel as though I learned something new.
Great documentation
Keep the webinars coming!
Information is always presented organized and well explained, I thank you for the opportunity to participate!
I mostly to inpatient coding/auditing, so I appreciate another perspective re: hospital coding/billing.
I loved how you emphasized the importance of procedure documentation for facility vs physician was that for the facility it was just that the procedure took place, and for the physician it includes the findings!
I have not ever done facility coding, so it was extremely beneficial to see how it compares & contrasts with profee coding.
I enjoyed the pauses for questions and reviewing them. The real-life scenarios were also very helpful and made the presentation more interesting.
LEARNED THE INPT SIDE OF HOSPITAL CODING
I thought this webinar did a really nice job of explaining the two different claim forms for facility versus professional billing. This webinar also did a great job at describing what diagnosis codes and documentation are used on facility billing versus professional fee billing.
This webinar was very informative.
Love the scenarios!
Very informative
This webinar was great and very informative.
I did not realize the differences between hospital and clinic billing as I’ve never seen the hospital side.
great info
It was a great referesher for me on claim forms, as well as a reminder on E/M billing
Webinar was very informative thank you.
very informative on the billing side and how it is captured
very informative on facility and pro fee, thank you.
The speakers were well spoken and a great presentation. Very well done. Thank you!
Thank you so much. You did a great job and I understand all of it.
Thank you for the wonderful topic
Loved this! The proper way to code for a hospitalist was helpful since it was a similar circumstance I recently faced. It was challenging to learn by myself but the scenario helped me to see what I needed to do.
Loved the step by step examples of scenerios.
Both ladies presenting were great!!
LEARNED THE DIFFERENCE BETWEEN A UB04 AND 1500 FORMS
very helpful
the clear explanations were great
I am unfamiliar with E/M level coding for the facility side – so it was great to know how that level is chosen before it comes to me for coding.,
great presentation and easy to follow.
Great job
Excellent! Everything explained beautifully!!
The webinar covers many informative topics. I found the information on split billing to be very helpful in regard to how the claims are generated for payments.
I haven’t coded since we were using ICD-9, so it was really nice to see some similarities and key differences in coding/billing this many years later.