Billing for Incident-to and Split Shared Visit Services by Non-Physician Practitioners

Doing it Right in the COVID-19 and Post COVID-19 era!

The two basic types of care a Nurse Practitioner or Physician’s Assistant provides (other than direct) are well published by Medicare. The rules for Incident To and Split Shared visits are easy to find and were relatively easy to follow prior to COVID-19. During the Public Health Emergency (PHE) there are parts of these rules that have been waived to allow patients better and easier access to healthcare. But those waivers are temporary. Understanding the differences in pre and during the PHE rules is imperative for compliant billing with Medicare. For other insurances, identifying their descriptions of direct and indirect services along with their definition of a shared visit can present challenges in the Pre-COVID-19 era let alone during. All of these definitions and differences make up the knowledge one needs when working with a Nurse Practitioner or Physician’s Assistant providers.

The autonomy that these Non-Physician Practitioners (NPP) have can vary from state to state and insurance to insurance. Understanding the different practice scenarios that can be utilized will help you to maximize the work your NPP can do for you. Next, complete knowledge of the documentation requirements for the differing types of care the NPP’s can provide will keep your charting compliant. Lastly, how to bill for their services will assure you maximum reimbursement to the practice, again in a compliant manner.

Not forgetting Telehealth visits, for during the PHE, a brief summary of the NPP’s abilities for these services will be presented during the webinar. Jill will also provide references from CMS’s IOM policy manual and others.

Webinar Objectives

• Clearing up the confusion over Incident to and Split Shared Visits – Documentation requirements and payment differences – Who has to be where and when
• What is different for supervision these visits from Medicare’s perspective during the PHE???
• TelehealthVisits for NPP’s – explaining and understanding the scenarios available to NPP’s to provide their services

Webinar Agenda

• Defining Incident to services per Medicare
• Defining Split Shared services per Medicare
• Defining Direct services per Medicare
• Differing Insurances policies on the above
• Telehealth services
• The future of NPP’s in practices

Webinar Highlights

• For Medicare’s Incident to where does the supervising physician need to be?
• What was different with this during the PHE?
• How much does the physician need to document on a split shared visit per Medicare?
• Specific examples of different insurance policies that exist
• Patient care models – traditional office and provider based 
• Reimbursement differences

Who Should Attend

• Coders
• Billers
• Office Managers 
• Practice Managers 
• NP’s and PA’s