What are professional fees in healthcare?

In institutional billing, clinics and hospitals charge fees for their services to patients and then bill insurance companies and patients. When doctors directly bill patients for their services, it's called professional billing. Professional fees paid to a doctor or medical provider are likely to be charged according to the services provided or the procedure performed. Most doctors have a list of services they offer to their patients, as well as a corresponding fee scale for those services.

A large part of the payments for medical services are paid by insurance companies, so payment may not be required at the time the service is provided; however, if insurance coverage is used, the medical provider will generally request confirmation of the coverage before providing the service or performing the procedure. Free billing for a fee only includes the expenses necessary for those professional services. If you're billing for a doctor's time and skills, you'll want to add a 26 modifier to specific CPT codes. An example would be if a patient undergoes a CT scan and has a doctor interpret the results for him.

In this scenario, the issuer of the bill would use the code 77014-26 to indicate to others that only professional services are being charged. Free billing is used when you only charge for the services of a professional.

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