tci Medicare Compliance & Reimbursement - 2010 Issue 11

Reader Question: Don't Overlook Shared Visit Billing for Inpatients

Question: I know I cannot bill services incident-to in the hospital setting. Is there any other option to capture the most value from time a non-physician practitioner (NPP) spent with a patient?Answer: Yes, you can bill split/shared E/M services in the hospital setting under the doctor's National Provider Identifier (NPI).The catch: The physician must provide a substantive portion of the service. This definition comes from the Medicare carrier First Coast: A split/shared visit is a medically necessary encounter with a patient where the physician and a qualified NPP each performs a substantive portion of the evaluation and...

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