Nurse Practitioner


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Hello everyone

My physician has a nurse practitioner that sees patients in the hospital. I bill for the visits at the office with the POS 21, but my physician asked me about billing for the nurse practitioner as well. Do I bill for both for the same DOS?


True Blue
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If the physician and the nurse practitioner are both seeing the same patient on the same day, this would be a 'shared visit' and you would only bill once for the services of both. Here is the guidance on this from the Medicare manual:

When a hospital inpatient/hospital outpatient (on campus-outpatient hospital or off campus outpatient hospital) or emergency department E/M is shared between a physician and an NPP from the same group practice and the physician provides any face-to-face portion of the E/M encounter with the patient, the service may be billed under either the physician's or the NPP's UPIN/PIN number. However, if there was no face-to-face encounter between the patient and the physician (e.g., even if the physician participated in the service by only reviewing the patient’s medical record) then the service may only be billed under the NPP's UPIN/PIN.