Wiki Nurse Practitioners billing

[nellt]

I have a few Medicare claims that were sent in error under the supervising physician NPI and not the Nurse Practitioner. Place of service is 22 Outpatient Services. I am correcting the claims.
Question is can a Nurse Practitioner bill a New Patient Charge? Or does she need a supervising because it is a new problem to the NP?

 

[RaeannLong]

The NP can perform new patient visits under physician's Medicare number if the physician is present in the room for the assessment and treatment plan. It must be documented in the note that the physician was present, or they can just do their own note for their portion of the visit.

 

[OCD_coder]

I partially disagree with the above statement, a supervising provider needs to do more than "be present" in the room. A portion of the service needs to be performed by the provider and documented by the provider to bill under their NPI #. If the provider and midlevel perform equal work then they can decide whom to bill under. I recommend that a coder know and understand what are the requirements of their Medicare MAC.

Novitas Rules for Split/Share documentation and reporting:

•Physician must provide a face-to-face encounter with the patient
•Physician must document at least one element of the history, exam and/or medical decision making component
•Physician signature (legible) to justify involvement in the patient care
•Non-physician practitioner's service must be within scope of practice
•Both practitioners currently enrolled in the Medicare program

 

[mitchellde]

A share visit cannot be performed on a new patient see CR1776