Wiki Help billing for a NP

[charbanc]

Hello,

1.Do I need to use Modifier SA when billing for a NP?

2. If so, is it only certain insurances?

3. Can a NP see patients without the physician in the office if they are still pending credentialing?

Any help would be appreciated.

 

[mitchellde]

The SA is more payer specific. No an NP cannot see patients without a physican on site if they are not yet credentialed, unless you are going to bill the service out of network. However the payient must be informed that it will be an out of network encounter.

 

[charbanc]

Do you happen to know which payers require the SA modifier?

thanks

 

[mitchellde]

No I do not. You should be able to look on the website of all the payers you have contracts with. It should say it there.

 

[charbanc]

Thank you!