Wiki Medicare signature rules

[kimsilviapare]

Hi all! I have a question about MDs cosigning for NPs in the record. It is the practice of my hospital (in MA) to have MDs cosign any treatment plans, progress notes, etc. that are signed by an NP. This only applies to MBHP and Medicare insurances though. Is this normal? I couldn't find anything about cosignatures on the cms.org site.

 

[csperoni]

Cosigning requirements can be established by the state. Even if state law does not require it, many hospitals and/or healthcare organizations have an internal policy regarding cosigning. This is regarding scope of work (and internal policies), which is completely separate from billing.
Regarding billing: If the patient (inpt) was seen by your NP, and MD cosigns note, this does not qualify as split/shared billing, and you bill under the NP. If that inpatient was actually seen (face to face) by both your NP & MD the same day (and it is documented as such), you may combine the documentation and bill under your MD.
It is important not to confuse billing guidelines with scope of work or internal policies.
I hope this helps.