Revenue Cycle Insider

Question: In our facility, a nurse practitioner (NP) works in tandem with a physician, and sometimes they split/share services during an encounter. Can either the NP or the physician sign the record/documentation of the service?

South Carolina Subscriber

Answer: Medicare Administrative Contractor (MAC) Palmetto GBA says that documentation in such a situation can be signed by either the nonphysician practitioner (NPP) or the physician. However, if the service is billed under the physician’s national provider identifier (NPI), then the billing physician needs to sign.

Palmetto GBA also says “the documentation must include a statement that the billing provider had face-to-face contact with the patient and performed a substantive portion of the E/M visit. (A substantive portion of the E/M visit includes at least one of the three key components — history, exam, or medical decision making.)”

Make sure you check with your patient’s respective payer if they’re not a Medicare beneficiary. Most commercial payers accept split/shared services, but their policies for reporting and billing these services may vary.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC