Consultations with a Beneficiary's Family and Associates

Physicians may contact a beneficiary's relatives or close associates and bill the patient for interviews needed to obtain background information for diagnosis and treatment, including when the patient is withdrawn/uncommunicative or comatose. Family counseling is covered only when its primary purpose is the treatment or management of the patient's condition (for example, observing patient-family interaction or assessing family members' ability to assist); counseling aimed primarily at treating the family member is not reimbursable. When the beneficiary is not a hospital inpatient, Part B reimbursement for interviews related to mental, psychoneurotic, and personality disorders is subject to a special payment limitation.

"Physician may contact relatives or close associates to obtain background information to assist in diagnosis and treatment when the patient is withdrawn and uncommunicative due to a mental disorder ..."