Use 4 team-based care scenarios to refresh your billing knowledge

Why This Topic Matters

Team-based billing can affect how services are reported and reimbursed, and mistakes may create compliance risk. The article helps readers recognize the kinds of encounters that warrant closer review during staff training and billing audits.

Article Sections

1. Introduction

   Introduces the Medicare billing topics covered in the article and explains why practices review team-based encounter workflows. It also frames the compliance risk associated with collaborative care billing.

2. Use 4 scenarios during your next training session

   Describes the purpose of using scenario-based training for incident-to and split/shared billing education. It summarizes the instructional approach and identifies the kinds of encounters discussed later in the article.

3. Scenario 1

   Presents a team-based office encounter involving a planned follow-up procedure and discusses the billing approach in general terms. The section focuses on physician and non-physician practitioner participation within a practice setting.

4. Scenario 2

   Covers a follow-up counseling visit performed by a nurse in a physician practice and the related Medicare billing considerations. The section highlights how staffing role affects the type of service being reported.

5. Scenario 3

   Reviews an inpatient collaborative visit involving a physician and a physician assistant. The section addresses shared work in a hospital setting and references CMS guidance relevant to split/shared services.

6. Scenario 4

   Describes a follow-up office encounter with a clinical nurse specialist after an earlier physician visit. The section focuses on how collaborative outpatient care is reviewed for Medicare reporting.

7. Resources

   Lists related CMS and enforcement references provided with the article for further reading. This section serves as source material and background documentation.