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Mar 19th, 2019 - anitac

nurse practitioner/hospital charges

Are codes 99221-99233 billable for nurse practitioner to Medicare?

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Apr 3rd, 2019 - AMat    2 

re: nurse practitioner/hospital charges

Please see MLN matters: MM5221 Revised

As long as they are credentialed they are no different than a physician. They cannot bill incident to for inpatient coding, but split share is possible.

Medicare Part B 101 Manual-Direct Billing/Payment for NPP Services Furnished to Inpatients and Outpatients
Nurse practitioners (NP), clinical nurse specialists (CNS), and physician assistants (PA) are authorized to bill Medicare carriers directly for their professional services when furnished to hospital patients, both inpatients and outpatients. The employer of a PA, rather than the hospital, must bill the carrier for their professional services when furnished to hospital patients. Hospitals should not bill for the professional services of a PA, unless the PA is employed by the hospital.
The professional services of NPs and CNSs furnished to hospital inpatients and outpatients may be billed directly by the NP or CNS to the carrier under their respective NPI.
The employer of a PA may bill the carrier directly for the professional services of the PA furnished to hospital inpatients and outpatients under the PA’s NPI number.
Hospitals may bill the carrier for the professional services of an NP or a CNS furnished to hospital inpatients and outpatients when payment for the NP and CNS services has been reassigned to the hospital and when the hospital bills for these services under the NP’s or CNS’s NPI number.

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