Wiki CPT codes billing for NPs

[SHobbs]

Can someone give me some direction on how to find the CPT list that are linked to be billable for NPs? I had a denial from an insurance company on a 99202 for a NP stating they could not bill for that service and the insurance company advised that I go to AMA for that list. I have searched and searched and can not find it. Any help would be appreciated

 

[cheermom68]

NP

I am not aware of any such list. This is normally determined by the State Scope of Practice for NP's in your state. If your particular state does not allow NP's to see new patients that would explain why it was denied. Incident to does not allow NP's to see new patients and bill under the MD's NPI number, but if you billed under the NP's NPI number this would not apply.

LeeAnn

 

[kbarron]

We use the md of the day as the billing provider. some states do not recognize Mid Level Providers as primary care. They provider the sevice only...MCR requires a GF modifier to tell the difference...Does this ins co want the same.?...