Wiki NP= Plan of care how to bill

[melindafarrell]

We have 2 physicians 1 NP and 1 PA. If the PA or NP see a new patient but the physician, who is on site, writes the plan of care and both PA or NP and physician sign the note with a comment about the physician writing the plan of care how is this billed? DO we get the 100 % reimbursement or the 85%?

 

[mitchellde]

You cannot bill a new patient or consultation encounters as incident-to. Therefore you use the NPI of the one that performed the evaluation with the patient, the NP or the PA. In most cases this will be 85%. However if the NP or PA is not credentialed with the payer then you will have issues with reimbursement.