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CodingIntel

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

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March 25, 2023

How Physician Services are Paid

PhysicianServicesPaid

Use the resources here to quickly educate new practitioners and staff about coding and reimbursement. You'll find explanations about code sets and compliance, about Medicare incident-to and shared services rules, and requirements for billing for services provided jointly between a resident and an attending.

Code sets and reimbursement Expand
    • As time goes by
    • How Physician Services are Paid – Coding guide
    • How Physician Services are Paid – Overview 
    • How Physician Services are Paid – Infographic
    • How Fees are Set in the Medicare Fee Schedule
    • 2022 RVU table with national fee amounts
    • Payment denials for unspecified codes
    • Physician specialty codes and claims processing
    • Facility versus Non-Facility in the Physician Fee Schedule
    • Who is responsible for coding physician services?  The medical provider or the coder?
    • What is a Coverage Policy?
    • Diagnosis Coding | Not just for claims anymore
    • Dear Resident, Do you understand relative value units?
    • How old is your oldest CPT book
    • Skin test for tuberculosis (PPD)
    • Two visits for the price of one? | Multiple medical visits on the same day
    • OB Coder Survey | Billing extra visits during pregnancy
    • 99072 – new CPT® code for supplies, equipment and staff time during the public health emergency
    • Delayed for three years: HCPCS add-on code G2211 for visit complexity
    • Coding Principles for Practice Administrators | Webinar
    • How medical practice services are paid | Webinar
    • 2021 Reimbursement: What Your Practice Needs to Know | Webinar
    • Best Practices in Revenue Cycle Management | Webinar

 

Medicare incident-to and shared services Expand
  • CMS’s 2023 shared or split services policy: document and report them correctly
  • CMS Split/Shared Services Rules | Reference Sheet
  • Medicare Incident-to and Shared Services | Coding Guide
  • Incident To Services – Medicare
  • Shared Visits – Medicare
  • Non-physician practitioners in nursing facilities
  • Medicare Rules for Incident-to Billing and Shared Services | Webinar
Teaching physician rules Expand
  • Teaching Physician Rules Coding guide
  • Teaching Physician Rules Quick Reference Guide
  • Teaching Physician Rules – Evaluation and Management Services
  • Teaching Physician Rules – Surgical procedures
  • Teaching Physician – Primary Care Exception
  • Teaching Physician Rules – Psychiatric Services
  • Teaching physician rules – Bedside procedures
  • CMS Teaching Physician Rules Update | Webinar
Compliance issues Expand
  • This practice paid Medicare $4.48 million
  • 7 sure fire ways to owe the government $4 million in fines and repayments | Coding Compliance
  • No Chart Left Behind: Deadline to Complete Medical Records
  • Billing physician services for hospice patients
  • Billing physician services for hospice patients | Reference Sheet
  • Wellness visits and care management in Rural Health Centers and Federally Qualified Health Centers (RHCs and FQHCs)
  • CMS update on medical record documentation for E/M services
Medical record documentation Expand
  • CMS update on medical record documentation for E/M services

2023 E/M reference sheets

These handy quick reference sheets included at-a-glance MDM requirements for office, hospital, nursing home and home and residence services. And, a bonus sheet with typical time for those code sets. Sign up for Betsy’s monthly newsletter to download these reference sheets and share them with your practitioners.

Sign Up Now

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

Latest Intel

Coding for hospital services | Webinar

Coding for hospital services April 20, 2023 … Read More...

CMS Split/Shared Services Rules | Reference Sheet

Download Reference Sheet Split/shared services … Read More...

Chronic Care Management | Reference Sheet

This quick reference sheet includes clinical staff … Read More...

Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse | HCPCS Code G0442

The  US Preventive Services Task Force (USPSTF) … Read More...

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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. For more about Betsy visit www.betsynicoletti.com.

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