Primary Care Coding Alert

Question: Please verify the correct way to bill for a nurse practitioner. When the NP provides unsupervised services, I bill the codes under the nurse practitioner's number. For supervised visits, I use modifier SA. Would I bill using the rendering or the supervising provider's NPI? Will payers reduce payment since it's for a supervised visit?California SubscriberAnswer: You should use HCPCS Level II modifier SA for supervised nurse practitioner services when the insurer requires the modifier. Some Medicaid programs such as Medi-Cal require you to apply Modifier SA to all NP services which are submitted under the physician provider number.Example: A nurse practitioner provides a level III established patient office visit to a Medi-Cal patient. The NP's FP supervises the service. To indicate the NP provided the office visit under direct supervision, you would append modifier SA (Nurse practitioner rendering service in collaboration with a physician) to 99213 (Office or other [...]