decisionhealth Newsletters, Answer Books - 2009 Issue 6 (June)
Shared Visits / Tips to bill shared visits
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Article Overview
This article explains the general Medicare framework for shared visits, with emphasis on inpatient and related settings where both a physician and a non-physician practitioner provide evaluation and management services on the same day. It is aimed at coders, billing staff, and compliance professionals who need to understand the broad policy distinctions, when a claim may be reported under different provider identifiers, and why certain situations may require an unlisted service approach. The article also notes operational considerations tied to claim submission and payer review.
Why This Topic Matters
Shared visits affect how professional services are reported and paid when multiple clinicians contribute to the same encounter. Understanding the applicable Medicare framework helps prevent billing errors and supports appropriate reimbursement.
What You Will Learn
- How Medicare treats shared evaluation and management services involving physicians and non-physician practitioners
- Which broad settings are discussed for shared visit billing
- Why employer relationships and provider participation affect billing choices
- What operational issues may arise when a shared service cannot be reported in the usual way
Who Should Read This
- Medical coders
- Billing specialists
- Practice managers
- Compliance staff
- Physicians
- Non-physician practitioners
Codes Discussed
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