split/shared visit

Strictly following the Medicare's Incident to guidelines, if the NP is seeing the patient and there is a change in care plan, it can no longer be billed incident to. Then the physician than comes in to review the new care plan with the patient.

What is needed to document this visit as a split/shared visit? A stamp that says, "A substantial portion of the visit was provided face to face by both the NP and myself relating to the History, Physical, and Care Plan" Or...

re: split/shared visit

There is no shared visit in office. It is either "incident-to or billed under provider performing the service.

re: split/shared visit

so then if NP saw the patient and does the history/exam part of the note, but doctor also see's the patient and does the a/p, can he still bill under his NPI. What is the documentation requirement in that case - where NP starts encounter but MD has to finish since it doesn't meet incident to

re: split/shared visit

The physician bills what he did, the HPI and the exam and medical decision making. The NP can still do the Ros and PFS. But, If the NP did bulk of visit (HPI, ROS, PFS and the exam) the NP should bill based on his/her MDM and H&P. under the NP number.

re: split/shared visit

FYI - split/shared visits can be done in the office per medicare guidelines and for level of billing, NP can do the Hx and state her part and I can do the MDM and state my part - buth which account for substantive part of the e/m.

re: split/shared visit

Bill for the service under the NPI of the rendering provider. IF the NP performed the service bill under the NP provider number.

This is a high risk area: don't bill under one provider's NPI if another provider performed the service.