Wiki Who can bill a 99211?

[cbeste]

We have community health workers at our clinic who do education and testing relating to diabetes and prenatal care, and I am wondering if they can bill a 99211 incident-to the physician using the physician's NPI number. I know that 99211 visits are usually considered to be "nurse visits." However, the CPT description of the code states only that it "may not require the presence of a physician or other qualified health care professional" and Medicare states that ancillary staff can bill a 99211 but I can't find a clear answer as to who they consider to be ancillary staff. Thank you in advance for any help with this!

 

[Cynthia Hughes]

CMS defines auxiliary staff as follows.
Auxiliary personnel means any individual who is acting under the supervision of a physician (or other practitioner), regardless of whether the individual is an employee, leased employee, or independent contractor of the physician (or other practitioner) or of the same entity that employs or contracts with the physician (or other practitioner) and meets any applicable requirements to provide the services, including licensure, imposed by the State in which the services are being furnished.(emphasis added)

Hope that helps.