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Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

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September 24, 2023

CMS Split/Shared Services Rules | Reference Sheet

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Split/shared services are evaluation and management services (E/M) services performed jointly between a physician and a non-physician practitioner (NPP), also called advanced practice nurses or physician assistants. CMS pays services performed by physicians at 100% of the physician fee schedule amount and services performed by NPPs at 85% of the fee schedule amount. When services are shared between those professionals, CMS requires that the claim is submitted by the practitioner who has performed by the practitioner who has performed the substantive portion of the service. What defines the substantive portion? Download the reference sheet and be sure.

July 19, 2023 update for 2024: CMS is proposing to continue the 2022/2023 definition of the substantive portion of the visit for 2024. They indicated this in the 2024 Proposed Rule, released 7/13/2023. We’ll know for sure when we see the Final Rule in November.

Additional resources:

  • CMS’s 2023 shared or split services policy: document and report them correctly

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Last revised July 19, 2023 - Betsy Nicoletti
Tags: medicare incident-to and shared services

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2023 E/M guidelines for hospital, nursing facility, home and residence services | Webinar

Effective January 1, 2023, the AMA has revised the definitions and guidelines for hospital and other E/M services, including ED visits, nursing facility services, home services, and domiciliary care codes. Also, coding for prolonged care services gets another overhaul with revised codes and guidelines. Watch this webinar about all these changes.

Watch it now

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions.

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