Medicare Compliance & Reimbursement

Question: I know I cannot bill services incident-to in the hospital setting. Is there any other option to capture the most value from time a non-physician practitioner (NPP) spent with a patient? Answer: Yes, you can bill split/shared E/M services in the hospital setting under the doctor's National Provider Identifier (NPI). The catch: The physician must provide a substantive portion of the service. This definition comes from the Medicare carrier First Coast: A split/shared visit is a medically necessary encounter with a patient where the physician and a qualified NPP each performs a substantive portion of the evaluation and management (E/M) visit, face-to-face with the same patient on the same date of  service. A substantive portion of an E/M visit involves all or some portion of the history, examination, and medical decision making components of the E/M service. Simply signing off on the NPP's note does not meet the criteria [...]