Provider Overhead Expenses

Policy ID: NDRP-GC-010

Section: General Coding

Effective Date: July 01, 2018

Revised Date: July 01, 2018

Last Reviewed: February 02, 2022

Applies To: Commercial and Medicaid Expansion

Description:

This policy addresses certain items that are considered part of a provider's overhead expense.

Type of Service

Definition

Overhead expenses

Overhead expenses include items such as facility/room fees, heat, light, rent, equipment, supplies and office staff.

Policy:

Expenses such as facility/room fees, heat, light, rent, equipment, and office staff are considered part of a provider's overhead expense and should not be billed separately from his or her professional services. Additionally, the cost of supplies (e.g., suture removal kits, surgical trays, electrodes) used in providing a covered professional service is included in the allowance for that professional service and should not be billed separately.

Disclaimer

Reimbursement policies are intended only to establish general guidelines for reimbursement under BCBSND plans. BCBSND retains the right to review and update its reimbursement policy guidelines at its sole discretion.

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