What is facility billing?

• A. Charging for services performed by physicians.
• B. Charging for services done in hospitals, skilled nursing facilities, rehabilitation centers, or ambulatory surgical centers.
• C. Billing for prescription medications only.
• D. Billing for administrative overhead.

Answer: (B)

Facility billing covers the charges for care that happens inside the healthcare setting itself—such as hospitals, skilled nursing facilities, rehabilitation centers, or ambulatory surgical centers. It accounts for the use of the facility, room and board, nursing, equipment, and other non-physician services during the patient’s stay or visit, and these charges are billed on institutional claims. In contrast, the physician’s professional services are billed separately as professional charges using CPT/HCPCS codes. Medications and pharmacy-related costs are handled through pharmacy billing or part of the facility charges in some settings, but not as the primary facility service. Administrative overhead isn’t billed as a separate patient service.