tci E/M Coding Alert - 2013 Issue 8

Reader Question: Check With Payer Before Adding SA

Question: When the NP provides unsupervised services, I bill the codes under the nurse practitioner’s number for supervised visits, I use modifier SA. Would I bill using the rendering or the supervising provider’s NPI? Will payers reduce payment since for a supervised visit?Idaho Subscriber Answer: You should use HCPCS Level II modifier SA (Nurse practitioner rendering service in collaboration with a physician) for supervised nurse practitioner services when the insurer does require this modifier. Some Medicaid programs such as Medi-Cal require you to apply modifier SA to all nurse practitioner (NP) services which are submitted under...

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