Wiki Billing Medicare

[maricelapinon1]

Hi.
I need help with how do I bill Medicare if our NP goes to see the Dr.'s patients in the assisted living facility. The Dr. usually goes but this time around the NP is going.

Do I need to use a modifier? Or do I just bill like if the Dr. was the one that went?

Any information I will really appreciate it.

 

[OCD_coder]

I would recommend reviewing the guidelines for "incident to" rules as these rules do not apply to an institutional setting like a skilling nursing or assisted living facility.

You would bill under the NP's NPI# if the physician did not perform any portion of the service on the same Date of Service. Your situation falls under Medicare's Split/Shared Rules. I don't know what MAC carrier you fall under, Novitas requires the physician to perform and document one of the three Key components of an E&M to meet Split/Shared documentation requirements.

http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/downloads/SE0441.pdf