In 2024, CPT® expanded its definition of split/shared services, CMS updated their requirements. Neither CMS nor CPT made changes tot his policy for 2025. CPT® expanded its definition of split/shared services in 2024, stating that the substantive portion can be determined by the practitioner who spent more than 50% of the time, or who made […]
Incident To Services – Medicare
Medicare has specific rules for billing for nurse practitioners and physician assistants and other office staff incident to a physician services in an office. This article includes: Description, explanation and codes for incident-to services Billing and coding rules Brief video overview Enrollment of non-physician practitioners (NPPs) for incident-to billing See our Medicare Incident-to and Shared […]
Shared Services: CPT® and CMS Rules | Webinar
Recorded May 16th, 2024
Shared services are E/M services jointly performed by a physician and non-physician practitioner in a facility setting. The service is reported under the National Provider Identifier (NPI) of the practitioner who performs the substantive portion of the service. The substantive portion of the service can be determined by time or medical decision making (MDM).
Non-Physician Practitioners in Nursing Facilities
Members can read more about nursing facility services here, and in Everyday Coding. Question: Can a physician assistant see patients in a nursing facility without a physician signing each encounter? How do we bill this? Can we do wellness visits in a nursing facility? Answer: A physician assistant or an advanced practice registered nurse may see […]
Coding Guide – Medicare Incident-to and Shared Services
This in depth guide reviews the requirements for billing Medicare Incident-to and shared services including: when/where these services can be billed, which provider number to use, and documentation requirements.