Reminder for Physicians: Postoperative Care Included in the Global Surgical Reimbursement Rate
The professional reimbursement for a global surgical period includes all the necessary services conducted by a surgeon or by members of the same group within the same specialty before, during and after a procedure.
In order to curb unnecessary costs incurred for follow up care provided in a facility setting, please ensure that your patient is well-informed on how and where to access postoperative care as part of discharge planning. Payment for postoperative services is included in the global professional reimbursement rate and care should be accessed in the physician office setting.
Postoperative services may include, but are not limited to, the following:
- Immediate postoperative care, including dictating operative notes, talking with the family and other physicians or other qualified health care professionals.
- Typical postoperative follow-up care related to the recovery of the surgery.
- Post-surgical pain management by the surgeon.
- Additional medical or surgical services required of the physician during the postoperative period due to complications to the surgery that do not require an additional surgical procedure in the facility setting.
- Miscellaneous services including but not limited to, dressing changes, incision care, removal of operative pack, cutaneous sutures and staples, lines, tubes, wires, drains, casts and splints; the insertion, irrigation and removal of catheters, nasogastric and rectal tubes, routine peripheral intravenous lines, and any changes and removal of tracheostomy tubes.
For more information on the global period of care, refer to the Global Surgical Package (CPCP014) policy in the Clinical Payment and Coding Policies under Standards and Requirements on the provider website or contact your BCBSTX Network Management Representative.