Wiki NP's and supervising physicians

[webspinner1@att.net]

Who is the referring provider when you are billing under the nurse practitioner and the supervising physician has not seen the patient? Should you bill the supervising physician? Or use the nurse practitioner as the service, billing, AND referring? Realizing I can't bill "incident to".

 

[mitchellde]

The NP NPI will be the only NPI used on the claim if the NP s the only provider to see the patient in the practice for this diagnosis or if it is a new patient. Your cannot use a physician NPI as the supervising, referring, or ordering provider in box 17 or as the supervising/rendering provider in box 24J if he/she has never examined the patient for this diagnosis or for a new patient.

 

[ellzeycoding]

Another thing to think about, and I'm not sure if this was the original intent of the question, but I can read into it if I try hard enough...

If this is an established patient, and the NP is seeing the patient for an established problem and an established plan of care, and "incident to" is being followed, you bill under the supervising provide that day. It doesn't have to be billed under the original provider that first saw the patient and established the plan of care. So in essence, a different provider could be supervising today and has never seen the patient.

For this type of group practice, the provider that is supervising is the one that is billed on the claim, regardless of whomever saw the patient originally, and as long as "incident to" is being followed.