Understanding Incident to Billing, Split or Shared Visits, and Direct Billing for PAs and NPs

Join us for an informative webinar series designed to empower healthcare providers with the latest updates and insights into coding and billing practices for Physician Assistants (PAs) and Nurse Practitioners (NPs). Led by industry expert, Jill M. Young, these sessions will equip you with the knowledge and tools needed to navigate the complexities of billing for these valuable providers, ensuring compliance and maximizing reimbursement.

Session 1: Coding And Billing Updates For Physician Assistants

Healthcare provider shortages are being filled in many areas by Physician Assistants. This is especially true for hospital-owned practices. Whether in the hospital rounding, performing procedures or seeing patients in the office, these valuable providers are being seen more and more. CMS/Medicare calls them NPPs.  Other names include Mid-Levels or Physician Extenders.  Whatever the name, these valuable providers have three unique methods of billing available to them, per CMS/Medicare.  Other commercial carriers add a fourth.  Understanding each of these methods, what the patient care model is for it, and deciding which will work best for your practice is imperative to avoid non-compliant billing.  The area of billing for NPPs is one that I have seen where the logic is “because we have always done it that way” and not because of any carrier rules or policies.  This type of logic exposes your practice to audits, and possible sanctions if the “traditional way” of billing is not the current compliant way

CPT for 2024 has seen major changes in their Guidelines for Split or Shared visits. These changes are not surprising but need to be understood to see if your practice is following them in 2024. CMS/Medicare has also made a major change in their definition of Split or Shared visits and this may create compliance issues if the new Guidelines are not incorporated into your policies and procedures for the care your NPPs give. 

This timely webinar will give you valuable updates in Guidelines for your Physician Assistant for 2024 but will also review the other methods of billing for their services.  This will ensure that your practice can have compliant documentation, coding and billing of your Physician Assistant’s services.

Session Highlights:

• Scope of practice for PAs: understanding, significance, and implications.
• Billing methods: Guidelines, Policies, and Documentation requirements.
• Incident to billing: physician's role, documentation requirements, and billing processes.
• Split or shared visits: 2024 updates for CPT and CMS/Medicare rules.
• Direct Billing: complexities and compliance considerations.
• Physician Billing for PA services: requirements and compliance challenges.

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Session 2: Coding And Billing Updates Nurse Practitioners

The role of Nurse Practitioners (NP) continues to expand in the medical provider community.  Several years ago, they were found mostly in primary care settings, now they are found in surgical and medical specialty practices as well.  They are found with significant roles in both in the inpatient hospital, outpatient hospital and the office. 

Although there are at least three methodologies in billing for NP’s services, these are entirely dependent on the insurance payers’ rules and guidelines for them.  It is imperative that all parties involved understand what each of these methods are and how the guidelines affect how the practice utilizes and bills for the services of NP’s. 

One cannot assume that the rules for CMS/Medicare are the rules for all insurances.  That is far from the truth.  “Because we have always done it that way” is not a logic that is defensible when it comes to billing services and should no longer be even considered as a starting point.  Billing for NP services correctly can be tricky and errors in billing lead to takebacks and sanctions. 

Changes to CPT guidelines matched with CMS/Medicare’s significant changes for split shared visits in 2024 have caused significant changes in practice’s workflow.  If your practice has not seen changes in 2024 in this, you may not be using proper documentation and billing for services may be incorrect.

This timely webinar will give you the valuable updates in Guidelines for your Nurse Practitioner for 2024 but will also review the other methods of billing for their services.  This will ensure that your practice can have compliant documentation, coding, and billing of these provider’s services.

Session Highlights:

• Scope of Practice for NPs: state-to-state differences and implications.
• Incident To: documentation and billing of this often misunderstood concept.
• Split or Shared Visits: guidelines for 2024 and documentation requirements.
• Direct Billing: simplifying documentation and billing processes.
• Supervised services by NPs: understanding limitations and requirements.
• Surgery and Procedures: NPs' roles and documentation necessities.

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Who Should Attend

Coders, Billers, Auditors, Office Managers, Office Administrators, Nurse Practitioners, Physicians