Wiki New to billing for Nurse Practitioner

lnemeth89

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Our Neurology office will begin billing with our Nurse Practitioners starting January 1. Can anyone lead me in the right direction on how to bill their office visits? The information I have found so far has been a bit confusing to me.
 
The billing for NPs is no different from billing for physician, unless the office is considering 'incident to' billing (i.e. billing the NP's services using the physician's credentials). Is it the 'incident to' guidelines that you're finding confusing or is there something else? If you have more specific questions it might be easier to help get you the information you're looking for.
 
I suppose my biggest question is what, if any, modifiers are needed. We will be billing under the NP's credentials. It's all new for our office and for myself as well. Thank you for your help. :)
 
I suppose my biggest question is what, if any, modifiers are needed. We will be billing under the NP's credentials. It's all new for our office and for myself as well. Thank you for your help. :)
No modifier is needed specifically for the NP unless one of your payers requires it, but in my experience that is rare. In all of my career, I've only encountered one payer (which was one state's Medicaid plan) that asked for the SA modifier for NP providers. If your NP is ever assisting at surgery, you'll use modifier AS instead of the 80 that you would use for a physician assisting. Other than that, as long as you're billing under the NP's credentials, you just code and bill their services as you would any physician's. Medicare payers will reimburse your NP at 85% of the physician's fee.
 
I also have a questions on Nurse Practitioner billing under NPI. If NP has left the practice without signing off the charts, can the delegating physician signs off their charts?
 
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