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Wiki Nurse practitioner coding/billing for a Consult?

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christyboutwell

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Can a nurse practitioner bill a consult code? A couple NP are starting at our office and I'm trying to get all my ducks in a row with the E/M charges. I've found documentation stating they can't and they can. I just need some clarification if anyone can help!
 
Yes they can.

When requested by a physician or other appropriate source, a consultation may be provided by a physician or qualified nonphysician practitioner (NPP). In order to be a qualified NPP, performing a consultation service must be within the scope of practice and licensure in the state in which the NPP practices.
 
HOWEVER!!! If they are Medicare patients you will only get 85% for the NP. TO GET 100% of fee schedule they would have to meet " incident to" rules and you can't do that with a consult. the md is required to make the treatment plan.

just fyi
 
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