Wiki Billing for Nurse Practioners in POS 21 & 22

[jjkjones@yahoo.com]

Hello all!!!

Our practice has been billing NP's for a few years now. We have never had any issues, until recently.

Just wondering how they are billed in the hospital setting. Are they the "rendering" provider or does it get billed under the doctor?

Any info would be helpful.

 

[thomas7331]

"Incident to" billing is not allowed in a facility place of service, per CMS regulations, so any services performed by a mid-level provider must be billed under that same provider's credentials. If the NP and the physician both see the patient in the facility and both document performing a portion of an E&M service, then that can be billed under the physician as a 'shared visit' but otherwise the NP must always bill for their own services.

 

[Jolynn0726]

Our ASC has a knee injection clinic and the owners would like an NP to perform the injections. If the facility And the NP both bill for the 20610 code, how does reimbursement work? I have found several articles that state the NP can only bill as long as the facility does not bill for the same service. HELP!