Wiki Split/Shared services

[mwells2020]

I am in a Rural Health Clinic and have a scenario that I am needing help with. One of my PA's saw a patient for shoulder pain. Referred this patient to one of my MD's for an ultrasound guided injection on the same day. If the PA does documentation and puts in a charge as well as the MD for the injection, can I bill for both of these services? They both could possibly have the same diagnosis. If I put a 25 modifier on the E/M would this help the visits to pay? Thank You in advance for your help!

 

[mckaya]

The 2022 MPFS Final Rule requires that the Split/Shared Visit encounter be billed under the provider who performed “the substantive portion” of the encounter. In the Final Rule, CMS intended to define the “substantive portion” of the encounter as being more than half of the total time dedicated to the patient encounter. (Taken from https://hsgadvisors.com/articles/the-2022-cms-split-shared-visit-rules-and-the-anticipated-impacts)

Here is a link that was helpful to me on Split/Shared Services https://codingintel.com/cms-shared-or-split-services/

 

[mwells2020]

Thank You so much!