decisionhealth Newsletters, Answer Books - 2009 Issue 6 (June)
Shared Visits / Know the rules for providers who share EM services
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Article Overview
This premium article helps readers understand the Medicare framework for shared evaluation and management services and why it should not be confused with teaching physician guidance. It is aimed at coders, billing staff, compliance teams, and clinicians who work with physician and nonphysician practitioner encounters. The article gives a high-level overview of where the split/shared policy applies, how CMS characterizes the provider relationships involved, and what makes teaching physician situations a separate issue.
Why This Topic Matters
Shared E/M billing is an area where similar-sounding rules can be applied incorrectly. Understanding which Medicare policy applies to a given encounter helps reduce billing errors and supports more accurate claims processing in settings involving physicians, nonphysician practitioners, and residents.
What You Will Learn
- How Medicare distinguishes split/shared E/M services from teaching physician rules
- Which types of provider relationships fall under split/shared guidance
- Why resident-involved services are treated differently from physician/nonphysician practitioner shared services
- Where the article points readers for the underlying Medicare guidance
Who Should Read This
- Medical coders
- Billing specialists
- Compliance professionals
- Physicians
- Nonphysician practitioners
- Resident and teaching physician stakeholders
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