Wiki CRNP vs MD billing

[rockylopez]

Hello Everyone. I have a question. I am currently auditing a Pain Management office in which i am noticing CRNP is seeing the patients as a follow up for routing medication management. The note it signed off by the CRNP but the claim was send under the MD for rendering and supervising. Can anyone give me any guidance on this one. I wanted to suggest to the office if the MD was going to be the rendering and supervising I believe the MD would have to write an attestation on the note. I know shared visits are not approved anymore by CMS since January 2022 but this does this count as an incident-to visit?
If anyone can give me some guidance as i need to present my findings a the week with the providers i would greatly appreciate it.
Thank you.

 

[csperoni]

This could be incident-to if it meets the requirements. Namely:
1) Billing MD must be on-site in the office suite and immediately available
2) Established problem
3) Established plan of care
It would seem routine medication management would likely meet #2 & #3 from above, but #1 must be met as well.

 

[rockylopez]

This could be incident-to if it meets the requirements. Namely:
1) Billing MD must be on-site in the office suite and immediately available
2) Established problem
3) Established plan of care
It would seem routine medication management would likely meet #2 & #3 from above, but #1 must be met as well.

thank you for the information. This is a pain management office and i am not too familiar with this specialty.

 

[csperoni]

You're welcome. I forgot to mention that this is assuming the carrier follows incident-to rules.
Incident-to is not specialty specific. IF the carrier uses incident-to AND it meets the requirements, then NP/PA/CNM visits may be billed under the physician's name.