ED Coding & Reimbursement Alert - 2020 Issue 11
Reader Questions: Understand Split/Shared to Receive Full Reimbursement
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Article Overview
This reader Q&A reviews the general concept of split/shared visits and how they are treated in Medicare billing, with attention to evaluation and management services, site-of-service considerations, and common payer variations. It is aimed at coders, billers, and practice staff who need a practical understanding of how physician and advanced practice provider services may be reported without going into code-specific instructions.
Why This Topic Matters
Understanding split/shared billing affects how a practice reports work performed by physicians and qualified advanced practice providers, which can influence reimbursement and compliance. The article also highlights that payer policies are not always uniform, making it important to know when Medicare-style guidance does or does not apply.
What You Will Learn
- The general concept of split/shared visits
- How split/shared services relate to evaluation and management reporting
- Which types of service locations are discussed in relation to shared services
- Why payer-specific billing rules matter
- The difference between physician and advanced practice provider reporting from a reimbursement perspective
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice managers
- Physician office staff
- Advanced practice provider billing teams
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