decisionhealth Newsletters, Part B News - 2011 Issue 4 (April)
Wellness visits can be performed by non-physician, billed by physician
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Article Overview
This Find-A-Code article discusses Medicare billing policy for annual wellness visits when the service is performed by non-physician staff under a physician’s supervision. It focuses on the CMS explanation of direct supervision, the relationship to incident-to concepts, and why the billing arrangement affects payment under Medicare Part B. The content is relevant to physicians, practice managers, coders, and billing staff who need to understand how CMS describes this wellness-visit scenario.
Why This Topic Matters
Understanding the billing framework for wellness visits helps practices avoid misinterpretation of supervision and payment rules and supports correct Medicare claim submission for services performed by clinical staff under physician oversight.
What You Will Learn
- How CMS frames Medicare billing for annual wellness visits performed by non-physician staff
- What direct supervision means in the context of these visits
- Why the article distinguishes this billing scenario from incident-to concepts
- How the payment context differs when billing under a physician versus a non-physician identifier
Who Should Read This
- Physicians
- Practice managers
- Medical coders
- Billing staff
- Non-physician practitioners
- Compliance staff
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