tci Medicare Compliance & Reimbursement - 2013 Issue 19

Shared Visits: Avoid Becoming a CERT Statistic and Paybacks

Use the tips given below to find out when NPP, physician can combine forces. You have to report split/shared visits properly to avoid paybacks or underpayments. Check out when you must report an encounter with the physician’s NPI and when only the NPP’s NPI can be used. In the office setting: Incident-to billing is a vital part of the practice’s reimbursement machine. Under incident-to rules, qualified nonphysician practitioners (NPPs) can treat certain patients and still bill the visit under the physician’s National Provider Identifier (NPI). The hospital setting, however, is a different story, since incident-to...

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