Medicare Compliance & Reimbursement - 2013 Issue 1
Reader Question: Can the Attending Bill For A NP's Procedure? Give Credit Where Credit is Due.
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Article Overview
This reader question explores a common hospital and emergency department billing scenario involving nonphysician practitioners, attending supervision, and Medicare billing rules. It is aimed at coders, billers, compliance staff, and physician practice managers who need to understand how facility-based procedures and shared service concepts are treated differently. The article focuses on general billing guidance, supervision context, and the limits of physician billing for work performed by an NP or PA.
Why This Topic Matters
Understanding the difference between procedure billing and shared E/M billing helps organizations avoid improper claims, compliance risk, and confusion about who may report services in a facility setting.
What You Will Learn
- How billing questions arise when a nonphysician practitioner performs a procedure in a hospital setting
- How facility-based procedure billing differs from shared evaluation and management service concepts
- How Medicare guidance is referenced in the context of attending physician billing and supervision
- What general compliance considerations matter in emergency department and hospital workflows
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Physician practice managers
- Hospital revenue cycle teams
- Emergency department administrators
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