tci Medicare Compliance & Reimbursement - 2006 Issue 7

REIMBURSEMENT: Medicare Expands Coverage For NPP Visits

SNF's and standard NFs have new reimbursement and billing options.Qualified non-physician practitioners working in both skilled nursing and standard nursing facilities can now obtain reimbursement for patient evaluation and management visits. The new policy covers nurse practitioners, physician assistants, clinical nurse specialists and other NPPs for medically necessary E/M visits before or after a physician's initial comprehensive assessment visit.In SNF settings, a physician must always perform the initial visit, according to a recent Centers for Medicare & Medicaid Services Medlearn Matters article. After the initial visit, physicians may delegate alternating, federally mandated follow-up visits to NPPs, regardless...

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