How Bayside Charges Work
Bayside contracts directly with your facility at a flat per-procedure rate. Bayside does not bill residents or insurance plans. The service agreement and payment arrangement are directly between Bayside and your facility.
Facility Billing Guide
Billing & Reimbursement
A quick-reference billing guide for facility administrators, SLPs, and Directors of Rehabilitation. Bayside does not bill residents or insurance plans. Explore the billing process, documentation, plan types, and coding information below.
Billing and coding information is provided for general reference only. Reimbursement rates, payer policies, and regulatory requirements change frequently. Consult your facility’s billing team or compliance officer for guidance specific to your payer contracts and patient population.
01 / The Basics
How Bayside Billing Works
Bayside Is Not a Third-Party Biller
All insurance billing is the facility's responsibility. Because a FEES evaluation is a therapy service performed by a therapist under the roof of your facility, consolidated billing rules apply.
The Facility Is Always the Provider
FEES is a swallowing evaluation performed by a therapist in your facility. Accordingly, the facility is the billing provider for any insurance reimbursement, not Bayside.
Potential Reimbursement
Under some insurance plans, the facility may capture reimbursement for a portion of the FEES cost (e.g. Medicare B, MCO/HMO; prior authorization may be required).
SOC Date: The FEES can be used as the Start of Care (SOC) date for a dysphagia patient. If billed on the same day as CPT 92610 (Swallow Eval), CPT 92612 requires Modifier 59 to identify it as a separate and distinct procedure.
02 / What Your Facility Receives
Reports & Documentation
What's Included in Each Receipt
- Resident name
- Date of service
- Applicable CPT code(s)
- Corresponding ICD-10 code(s)
- Bayside clinician information
Shared Facility Folder
Following each FEES exam, a detailed receipt is uploaded alongside the FEES report to your shared facility folder. This is accessible for 60 days by your facility SLP and/or DOR to download at any time.
EHR Documentation Options
Your facility SLP may bill dysphagia treatment time under CPT 92526 in your EHR system. Facilities may also grant Bayside’s clinician access to your EHR to enter CPT 92612 minutes directly, ensuring FEES services are captured in your month-end billing and utilization reports.
03 / Claims Workflow
Facility Billing
How to Bill Insurance for a FEES
To bill insurance, the facility must add CPT 92612 to their:
- UB-04 Institutional Billing (paper form), or
- 837-I (electronic claims)
Supporting Diagnosis Code
The supporting ICD-10 code for oropharyngeal dysphagia is:
R13.12
Oropharyngeal Dysphagia
Private Insurance
FEES is typically treated the same as any rehab evaluation by private insurance plans. If the plan requires pre-authorization for therapy evaluations, the facility may need to request pre-auth for the FEES swallowing evaluation before scheduling.
Reminder: Billing of a resident's insurance must be completed by the facility. Bayside is not a third-party biller and does not submit claims to any payer on the resident's behalf.
04 / Plan Reference
Insurance by Plan Type
Medicare Part A
The cost of the procedure is subtracted from the resident's day rate. It is not reimbursed separately under Medicare Part A consolidated billing rules.
Medicare Part B
Therapy procedures including FEES are billable by CPT code. Reimbursement varies by setting and locality. Contact your billing team or refer to the current CMS Physician Fee Schedule for your specific rate.
MCO / HMO
The cost of the procedure is subtracted from the resident's day rate. It is not reimbursed separately under managed care consolidated billing arrangements.
Medicaid
The cost of the procedure is subtracted from the resident's day rate. It is not reimbursed separately under Medicaid consolidated billing rules.
Private Insurance
Treated the same as any rehab evaluation. If pre-authorization is required for therapy evaluations, request pre-auth for the FEES swallowing evaluation. Facility bills the resident's plan directly.
05 / Coding Reference
CPT & ICD-10 Codes
CPT 92612FEES Procedure
Fiberoptic endoscopic evaluation of swallowing by cine or video recording. This is the primary procedure code for the FEES evaluation itself. Billed by the facility on the UB-04 or 837-I.
CPT 92526Dysphagia Treatment
Treatment of swallowing dysfunction and/or oral function for feeding. The facility SLP may bill this for dysphagia treatment time in your EHR system.
CPT 92610Swallow Evaluation
Evaluation of oral and pharyngeal swallowing function. If billed on the same day as CPT 92612, Modifier 59 is required on 92612 to identify it as a separate and distinct procedure.
ICD-10 R13.12Diagnosis Code
Oropharyngeal Dysphagia: the supporting diagnosis code used when billing insurance for a FEES evaluation. Include on the UB-04 or electronic claim.
Same-Day Billing Tip
When CPT 92612 and CPT 92610 are billed on the same date of service, append Modifier 59 to CPT 92612 to indicate it is a separate and distinct procedure from the swallowing evaluation.