Urology Coding Alert

Question: 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 for a supervised visit?Answer: You should use HCPCS Level II modifier SA (Nurse practitioner rendering service in collaboration with a physician) for supervised nurse practitioner services when the insurer does require this modifier. Some Medicaid programs such as Medi-Cal require you to apply modifier SA to all nurse practitioner (NP) services which are submitted under the physician provider number. Do not use this modifier for Medicare patients as this modifier is not covered or valid for Medicare and as such reimbursement may be denied.Example: A nurse practitioner provides a level three established patient office visit to a Medi-Cal patient. The NP's urologist supervises the service. To indicate the NP provided the [...]