Wiki Incident - to billing

[sroyal1031]

I have a question regarding the final rule and remote supervision as it applies to APP supervision and "incident to" billing practices



42 CFR §410.26



Can someone please clarify if remote audio/visual supervision only applies to nurse level visits E/M code 99211. My administrator feels that we are unable to bill for E/M services provided by an APP with remote supervision using incident to rules for codes 99212-99215

 

[Pam Warren]

Telehealth supervision applies anytime supervision is provided, including teaching physician services, ..... but the E&M code (or any code used) has to report services within the scope of the ancillary staff.

For example, nurse visits are only reportable with 99211, as they cannot perform the level of care represented by a higher E&M code. But you can report 99214 for example, if an APP is billing incident-to an MD, and if all other incident-to guidelines are being met (plan of care, no new patients, no new problems, etc.)