Wiki Hospital Shared Visits MDM

[toria11]

Am I correct that if a shared visit is being billed under the physician because they performed the MDM, the visit is leveled based on the physician's documentation alone? Like you can't combine the MDM from the APP and the MDM from the physician to level the shared visit, correct?

 

[jkyles]

Hi there, I would say that is correct for Medicare based on this statement from the final 2024 physician fee schedule:

whoever performs the MDM and subsequently bills the visit would appropriately document the MDM in the medical record to support billing of the visit

Also, when CMS first released its new split/shared rules it indicated it wanted to move away from scenarios where the physician performed a drop in visit but got full credit for the visit.

 

[toria11]

Hi there, I would say that is correct for Medicare based on this statement from the final 2024 physician fee schedule:


Also, when CMS first released its new split/shared rules it indicated it wanted to move away from scenarios where the physician performed a drop in visit but got full credit for the visit.

Thank you!! And their new policy makes it very easy for physicians to get full credit without seeing the patient at all. Just trying to make sure their documentation is adequate and that I'm leveling the visits correctly based solely on their MDM rather than anything the APP documents.