ED Coding & Reimbursement Alert - 2018 Issue 1
Reader Question: If You Work With APNs, Do This
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Article Overview
This article addresses a practical Medicare billing question involving advanced practice nurses, home visits, and incident-to reporting. It explains the general framework for when physician supervision matters, why the setting of care affects reporting, and who this guidance is intended for. The piece is useful for practices, coders, billers, and compliance staff who work with non-physician practitioners and home-based services.
Why This Topic Matters
Home-based care and post-discharge follow-up are common services, and incorrect incident-to reporting can create compliance risk. The article helps readers understand the broad billing and supervision concepts involved so they can assess whether their workflows align with the applicable rules.
What You Will Learn
- How incident-to billing is discussed in the context of APN-provided home visits
- Why physician presence and supervision are relevant to reporting
- How services by non-physician practitioners may be billed at a general level
- What kinds of practice scenarios the guidance applies to
Who Should Read This
- Medical billers
- Coders
- Practice managers
- Compliance staff
- Physician practices
- Nurse practitioner and APN billing staff
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