Wiki Split/Shared Office Visit Billing

[aayers0624]

What is your understanding on how to bill split /shared visits in the office setting when it comes to PA/NP's? How much of the office visit much the MD perform to be able to bill under the MD's NPI vs taking the 15% reduction and billing under the PA/NP?

 

[thomas7331]

As I understand it, there are two requirements that must be met to bill under the MD - 1) the patient must be established, and 2) all of the portions of the visit performed by the PA/NP must meet 'incident to' requirements. So in other words, the PA or NP must be employed by the MD, their services must be performed under the MD's direct supervision and be part of the MD's care plan for an established problem. If the patient presents with any new problems or concerns, or if any changes need to be made to the existing care plan(s) at that visit, then those portions of the visit must be personally performed by the MD at the visit. Otherwise, the visit must be billed under the PA/NP.