Wiki NP billing Please help

[HBULLOCK]

I am having a disagreement regarding billing NP's. I'm hoping someone can assist me. We are a Pediatric office. We are having a flu clinic on Saturday along with our urgent care/sick visits. There are two NP's on the schedule. I was always told that an MD had to be in the office with the NP's. They don't have to go in the room with them but MD has to sign off services. One of the NP's told me that was not neccessary, that she could work without a supervising MD here. We do not bill under our NP's, we bill under the supervising physician. I would appreciate any/all input on this asap. If I am in fact correct, I need proof. I'm checking the Federal Register also. Thanks so much!

 

[mitchellde]

If you bill under the MD NPI then you are billing incident to and the provider must have already visited with the patient and ordered the service as a part of the documented plan of care and the physician must be on the office suite at the time of service. If you do not have a physician on the office, and of the provider does not have a plan of care documented for this patient for this same problem the you cannot bill using the physian NPI, you can however bill under the NPs NPI.

 

[HBULLOCK]

Thanks so much for the response.

 

[debflutter]

I concur with the above. But, you need to follow the state guidelines for scope of practice.

Debi Miller, CPC, CEMC