BC Advantage - 2017 Issue 6

Inpatient Compliance: Split/Shared Services

In the inpatient setting, a physician can combine  his/her documentation with that of a non-physician provider (NPP) to support an E/M service while billing the resulting code under the physician. This is called a "split/shared" service and allows physicians to bill at 100% of the fee schedule rate even though some of the work was done by the NPP. If the NPP were to bill for such a service alone, he or she would typically be paid at 85% of the fee schedule rate.Last week's audit tip provided guidance on a similar billing policy, incident-to services, which allows...

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