In 2024, CPT® expanded its definition of split/shared services, CMS updated their requirements. Neither CMS nor CPT® made changes to this policy in 2025 or 2026.
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 the substantive portion of the service. What defines the substantive portion? Download the reference sheet and be sure.
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