Wiki Which provider on the claim?

SueTeal

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For interventional radiology claims, which provider do you bill out on the claim, the NP or PA that performs the study or the Radiologist that reads the study?
 
For interventional radiology claims, which provider do you bill out on the claim, the NP or PA that performs the study or the Radiologist that reads the study?

Depends on where the service was done (office vs. hospital), what codes were used, and who the payer was.
In the hospital, for Medicare, if the NP or PA provided the service then that person would have to bill, the radiologist cannot bill for a procedure he did not perform. If there are separate S & I codes for the procedure and the radiologist interpreted the exam, then the radiologist could bill the S & I. (this assumes that the procedure falls within the scope of practice for the NP or PA.)
In the office, either the NP/PA could bill or the radiologist could bill under incident to rules (and assuming that the radiologist provided the required supervision).
Other payers have their own rules regarding non-physician providers, so you would need to check with each of them.
 
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