Wiki Medicare guidlines for skilled nursing home visits

[LynnSC]

I am in need of help with the Medicare rules for a NP to see patients in a nursing home. Does the MD have to see the patient first, or can the NP
see the patient each visit and bill at the 85% reimbursment that
Medicare pays? Does an MD have to see the patient and if so how
many visits?
Lynn

 

[dvarn567]

Medicare guidelines for skilled nursing home visits

Yes the physician must do the initial H&P on a skilled nursing home patient. The NP can make a "medically necessary" visit without the physician initially seeing the patient if they have an issue that requires attention before the physician does the initial visit. All other visits may be done by the NP alternating with the physician.

 

[dvarn567]

Medicare requires visits every 30 days for the first 90 days after admission, then once every 60 days. More frequent visits, without documented medical necessity, may invite an audit. Some states don't allow NPs to perform all the required visits, but they can perform some of them, taking turns with the supervising physician