Get the Pay You Deserve in Group Practice Coding

Why This Topic Matters

Understanding these group practice rules can affect whether services are billed separately or considered part of a shared surgical package, which in turn influences compliant reimbursement and E/M reporting accuracy.

Article Sections

1. Use Modifiers to Separate Surgeries

   Discusses group practice billing during a postoperative period and the role of Medicare policy in separating surgeries performed by physicians in the same practice. It also addresses how carrier recognition of specialties can affect whether services are treated independently.

2. Modifiers Arent Necessary for Different Specialists

   Covers services performed by physicians in different specialties within the same group practice and how these situations are treated under Medicare and some commercial payer approaches. It also notes the issue of subspecialty recognition by carriers.

3. Report One E/M for Same Condition

   Explains reporting considerations for evaluation and management services when more than one physician in the same group sees the patient on the same date. The section distinguishes between visits for unrelated issues and visits focused on the same problem.