Owned Nurse Practitioners wants to bill for RN or MA outside services


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I work for a Nurse Practitioners office which she owns in the state of Wisconsin. The NP does do outside services in a local Assisting Living Facility. I have billed for the services at the clinic with a 99211 under the NP NPI number for the RN or MA.

The question the NP and mine of course is can the NP send her RN or MA to the Assisting Living Facility (outside clinic services) for a Wound Dressing change and bill for this? Can you direct me to the guide lines if the RN or MA Can or Can Not Do the services outside the clinic.


True Blue
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There isn't any easy answer to this question. As a very general rule, RN and MA services must be supervised on site by a provider in order to be covered - they cannot perform or bill independent E&M. If the assisted living is not a skilled facility, then these visits may be consider home healthcare and would fall under that regulation. In some rural areas where the are not enough home health agencies, I believe they allow providers to bill for services done by their staff in the patients' homes, but you would probably want to approach this cautiously and consult with you state's home health licensing regulations to see if this would be legal. If the facility is in fact a skilled or rehab facility, then it would most likely not be allowed - 'incident to' billing is generally prohibit in a facility.