Interpreter Services Billing: What Your Practice Can (and Can’t) Do

Billing for interpreter services comes up every time a clinic gets a big invoice from a translation vendor. We frequently get questions from clients asking if it is possible to bill for these services.

Here’s what we’ve found:

Payer / Party	Separate pay for interpreter?	How to bill or handle	Source
Medicare (Part B, RHC/FQHC, MA)	No – HCPCS T1013 is “not payable by Medicare” and gets bundled into the E/M visit.	Treat as overhead.	HCPCS Data
Most commercial plans	Rare. Most follow CMS bundling rules.	If a plan policy allows it, use T1013 and confirm limits in writing.	AAPC
Texas Medicaid	Maybe – using T1013. • Modifier U1 = first hour (1 unit) • Modifier UA = each extra 15 min (up to 28 units)	Submit on same claim as the medical service. Document the interpreter’s name and certification.	TMHP
Other state Medicaid programs	Mixed. Some reimburse; others treat as admin cost.	Check each state’s fee schedule or contract.	National Health Law ProgramMedicaid
Patients	Never. Language help must be free to the patient under Title VI, ACA §1557, and ADA rules (for sign‑language).	Absorb the cost or bill an eligible Medicaid plan.	HHS.govHHS.govADA Archive

In Brief

Interpreter services billing is patchwork: Medicare and most commercial plans fold the cost into the visit, some state Medicaid programs (Texas included) pay when you attach HCPCS T1013 to a covered service, and prolonged‑time codes can pick up any extra minutes—but federal civil‑rights law bars you from ever passing that interpreter charge on to the patient.

When Extra Time Counts

If the interpreter makes the visit run long, you may pick up legitimate time‑based E/M or prolonged‑service codes (e.g., 99417, 99354‑99357). Time must hit the CPT thresholds and your note must show the added work. See American Medical Association for more details.

Documentation Checklist

• Note that an interpreter was used.

• Record the interpreter’s name (or agency) and certification level.

• State why language help was needed.

• If you bill prolonged time, show total clinician‑face‑to‑face minutes.

Texas Medicaid audits interpreter claims for these details. Other payers can ask for the same. See TMHP for more details.

Why This Matters

• Compliance: Federal civil‑rights rules ban passing interpreter costs to patients. Violations trigger OCR complaints and payer audits.

• Revenue protection: You can recover part of the expense for Medicaid visits—money most groups leave on the table.

• Risk control: Clean, time‑stamped notes back up prolonged‑service claims and guard against recoupments.

Action Steps for Your Office to Consider

1. Flag LEP and deaf/hard‑of‑hearing visits in the EHR so coders see them.

2. Load HCPCS T1013 with modifiers into your charge master only for payers that pay it.

3. Train front‑desk staff to call an approved interpreter vendor instead of asking family members.

4. Track interpreter invoices against paid T1013 claims to gauge cost recovery.

5. Update your financial policy to state that patients are never billed for language help.