tci Medicare Compliance & Reimbursement - 2004 Issue 38
Physicians: Save The 'Shared Visits' Rule For The Hospital Ward
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Article Overview
This article discusses how shared visit rules apply in evaluation and management billing, especially the difference between hospital and office settings. It is aimed at physicians, nurse practitioners, physician assistants, and coding/billing professionals who want a clearer understanding of when shared visits, incident-to billing, and related office-based practices may apply. The article also addresses common misunderstandings about office workflows and highlights the broader compliance and scope-of-practice considerations involved in these services.
Why This Topic Matters
Billing and documentation for evaluation and management services can vary by care setting and provider roles. Understanding the limits of shared visit use helps practices reduce billing errors and avoid applying hospital-based concepts incorrectly in the office.
What You Will Learn
- How shared and split/shared evaluation and management concepts are discussed in relation to hospital and office care settings.
- Why office-based billing practices may raise compliance concerns when provider roles are combined.
- How incident-to concepts relate to office encounters involving non-physician practitioners.
- What broader practice and scope-of-practice issues are associated with these visit arrangements.
Who Should Read This
- Physicians
- Nurse practitioners
- Physician assistants
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
Codes Discussed
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