Make sense of new proposals to revise CPT coding, billing for split/shared visits

Why This Topic Matters

Split/shared visit policies affect how Medicare claims are assigned, documented, and tracked across physician and QHP collaboration. Understanding the proposal helps practices assess operational impact, documentation readiness, and potential compliance changes before the rule becomes final.

Article Sections

1. Overview of the proposed CMS changes

   Introduces the 2022 Medicare Physician Fee Schedule proposal and summarizes the overall policy shift affecting split/shared visit reporting.

2. Core elements of the proposed split/shared policy

   Covers the general setting, practitioner relationship, and service types addressed by the proposal, along with areas CMS says would remain unchanged.

3. Time-based reporting and practitioner attribution

   Discusses the proposed move toward time-based selection concepts and how CMS would attribute the service for reporting purposes.

4. Overlapping time and related ambiguities

   Summarizes CMS guidance on overlapping time and notes areas where the proposal leaves unanswered operational questions.

5. Other proposed revisions

   Reviews additional proposed changes involving a new modifier, documentation expectations, and related tracking requirements.

6. CMS requests for public comment

   Outlines the broader policy topics CMS seeks feedback on, including group definition and emergency department-specific considerations.

7. Early reaction hints at pushback

   Presents commentary from industry experts reacting to the proposal and describing likely implementation concerns.