Shared Visits: Avoid Becoming a CERT Statistic and Paybacks

Why This Topic Matters

Correctly distinguishing shared visits from other billing arrangements can affect payment, compliance risk, and whether a claim is subject to denial, overpayment recovery, or audit scrutiny.

Article Sections

1. Billing context for shared visits

   Introduces the relationship between office and hospital billing arrangements and explains why the article focuses on shared visits and related payment concerns.

2. Face-to-face time is a must

   Discusses the role of same-day physician participation, documentation, and CMS guidance for hospital and emergency department encounters. It also notes limits on where shared billing may be used.

3. Make sure physician is available

   Covers supervision expectations, provider availability, and the documentation elements needed to support shared-service billing.

4. Examples

   Provides illustrative CMS examples showing how shared visits may be documented and reported in different settings.