Wiki split/shared visits

[luvbuix]

i work for a moderate sized hospital based oncology practice. they have several APPs & want to start doing split/shared visits in the office. their plan is to have the APP do 20 mins of the appt & the MD 10 mins. the MD will be doing the MDM portion of the visit. according to Medicare's final rule this can be billed under the MD if he does one component of the visit in its entirety right??

 

[jkyles]

Hi there, I think you're mixing up hospital-based and office-based split/shared visits.

In the office (99202-99215) you code split/shared if you select the code based performance of the activities listed in the CPT manual. You'll need to check with your MAC to determine whether they have special rules for how you bill for split/shared in the office.

For hospital-based split/shared for 2022 you can bill based on time or key elements. (In 2023 you'll only have time.) In your scenario if you use time the APP would bill because they performed the substantive portion of the visit. If you use key components you'll bill under the provider who performs all of at least one key component. So if the APP and the doctor shared history and exam but the doctor did all of the MDM, you'd bill under the doctor's name. You'll use modifier FS with these services.