Here is a summary of R-CPD fees and charges for evaluation and treatment with the In-Office Injection. For the Outpatient Procedure under general anesthesia, go here.
Note: All BVI charges are billed to insurance companies through our National Provider Identifier (NPI) 1588449458
DISCLAIMER: The charges provided are an “accurate estimate” and are subject to change. (eligible for BVI 15% discount if paid in full by patient)
Office Exam[1] |
||
|---|---|---|
| Charge Fee | Description | Insurance Billing Code |
| $395.00 | Office Visit (BVI) | CPT 99204 |
| $567.00 | Videoendoscopic Swallow Study (BVI) | CPT 92612-GN |
| $100.00 | Review of Videoendoscopy | CPT 92613 |
| $1,062.00 | Total Office Exam Charges | |
Procedure |
||
|---|---|---|
| $653.00 | Chemodenervation | CPT 43192 |
| $650.00 | Botox (Not elligable for 15% discount, and must be paid for out-of-pocket.) | Cost of Botox with no markup |
| $1,303.00 | Total Procedure Charges | |
ONE WEEK LATER — (in-person or via telemedicine) |
||
|---|---|---|
| Follow-up appointment with Physician Assistant or Nurse Practitioner | ||
| $220.00 | Post-op visit | CPT 99213 (99213-GT if telemedicine) |
Total charges before insurance processes the claim — $2,486.00
Total charges with 15% discount if paid in full on the date of service — $2,211.00
BVI will submit a claim to your in-network insurance for Office Exam charges, Procedure Chemodenvervation charge, and One-Week Later post-op charge. BVI offers a 15% discount on our charges to those who pay in full at the time of service and who do not submit to insurance, EXCEPT for the cost of the vial of botox.
Please note, we will not bill to insurance for patients who live outside the United States. These individuals can submit a claim to their insurance company to be reimbursed for their services with us but will be required to pay out-of-pocket on the date of service, as well as leave a bank card on file for future scheduled services.
[1] – If your insurance company requires pre-authorization for this procedure, we are NOT able to help you obtain that until you have officially become a patient by having been seen by us in our office. Since each insurance company differs in coverage, this procedure has occasionally been denied as experimental and/or investigational. In the event this happens to you, we will help you appeal the denial.
The Diagnosis Codes used for billing are:
- J38.5 Laryngeal spasm
- R14.2 Eructation
- R14.0 Abdominal distension (gaseous)
- K22.4 Dyskinesia of esophagus
At your discretion, you may wish to contact your insurance company to verify coverage.