decisionhealth Newsletters, decisionhealth - 2010 Issue 4 (April)
Primary Care RoundUp: NPs and new patient visits
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Article Overview
This short Q&A article addresses a common primary care billing question about whether a nurse practitioner can see a new Medicare patient in an office setting. It focuses on Medicare incident-to requirements, direct billing under the NP’s own identifier, and where to find the applicable CMS policy guidance. It is useful for primary care billers, practice managers, and clinicians who need a general understanding of how Medicare treats NP services in these scenarios.
Why This Topic Matters
Billing a nurse practitioner’s services incorrectly can affect reimbursement and compliance. The article helps readers distinguish between incident-to services and services billed under the NP’s own billing identifier.
What You Will Learn
- How Medicare incident-to billing relates to nurse practitioner services
- When an NP’s services are billed under the NP’s own identifier versus incident-to
- Where to locate CMS guidance on incident-to policy for office-based services
- How the article frames new patient and new problem visits in a primary care setting
Who Should Read This
- Primary care practices
- Medical billers and coders
- Practice managers
- Nurse practitioners
- Physician office administrators
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