REIMBURSEMENT: Medicare Expands Coverage For NPP Visits

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers Medicare policy changes related to non-physician practitioner visits in skilled nursing facilities and nursing facilities. It outlines the facility settings affected, the types of visits involved, and the accompanying updates to Medicare reporting codes effective January 1, 2006. The material is relevant to coders, billers, compliance staff, and facility administrators who work with long-term care E/M services and Medicare payment rules.

Why This Topic Matters

It helps readers understand how Medicare expanded coverage for certain non-physician practitioner services in long-term care settings and what billing-related code updates accompanied the policy change.

Article Sections

  1. Policy update for nursing facility and skilled nursing facility visits

    Introduces the Medicare coverage update for non-physician practitioner visits in long-term care settings and identifies the affected provider types and facility settings.

  2. Billing and code changes effective January 1, 2006

    Summarizes the accompanying reporting updates for nursing facility care, discharge day management, and annual facility assessment services.

What You Will Learn

  • Which long-term care settings are affected by the Medicare update
  • Which practitioner categories are included in the coverage change
  • What types of visit categories are discussed in relation to facility billing
  • What general coding updates accompanied the policy change
  • Which effective date is associated with the revised reporting approach

Who Should Read This

  • Medical coders
  • Medical billers
  • Compliance staff
  • Long-term care facility administrators
  • Revenue cycle professionals

Codes Discussed

  • CPT: 99304
  • CPT: 99305
  • CPT: 99306
  • CPT: 99307
  • CPT: 99308
  • CPT: 99309
  • CPT: 99310
  • CPT: 99315
  • CPT: 99316
  • CPT: 99318

Code Ranges Discussed

  • CPT: 99304--99306
  • CPT: 99301--99303
  • CPT: 99307--99310
  • CPT: 99311--99313
  • CPT: 99315--99316

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