BC Advantage - 2014 Issue 10

Understanding Billing and Documentation Compliance with CMS' Incident To and Shared/Split Visits

This article addresses the billing and documentation relationship between physicians and what is commonly referred to as Non-Physician Providers (NPPs). NPPs are individuals who are licensed by states under different programs to assist or act in place of a physician. In this article, we will focus only on Nurse Practitioners (NP) and Physician Assistants (PA). There are two ways to bill for services that are provided by NPPs. The first way is to bill with the NPP's National Provider Identifier number (NPI) which is reimbursed at 85% of the Medicare Physician Fee Schedule (PFS). The other way is to...

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