Question about NP billing

Our practice, surgery, has never used an NP but are 'borrowing' one for just a few days to ease the Dr. load so he can catch up on some paperwork. He will be in the office at the same time and will do the exam and plan for each pt.... Can the NP dictate the HPI or does that need to be done by the Dr. as well? Do I have to do anything different with billing?

Question about NP billing

If you are borrowing an NP you can't bill at all for the services.

If you are contracting for the NP, and there is a market rate expense, then you can bill only for services that meet incident to requirements for Medicare. You'll have to check with other payers for their rules.

Incident to means that the physician must have seen the patient first at a previous visit (not just putting his/her head in at this visit), established the plan of care, initiated treatment, stayed involved with patient and is in the office when patient is seen. No new problems or new patients. If these are new patients to you, for Medicare, the situation you describe doesn't work.

they don't work as shared services in the office, unless they meet the requirements of incident to.

http://www.codapedia.com/-article_410_.cfm

http://www.codapedia.com/-article_356_.cfm

reply

Just to be clear, when you say contracting for the NP that would mean adding her to our contracts and billing under her NPI, correct? Borrowing was a poor choice of words as we will of course be paying her a salary, but if I am understanding correctly your point remains the same. Am I correct to say that sans adding her to our contracts she would only be able to help with re-evals and post-ops, and not consults/new patients?

Oh, I just noticed the links.... I will read now and probably have my questions answered. Thank you very much!!!

Thanks

I just read the articles, they are very clear. Thank you again for your help, I really appreciate it!