Dialmam
Networker
I code for professional charges for a health system that utilizes a provider based billing model. The organization has undergone a restructure and now many RNs that used to be employed by the physician practices are now employed by the facility. We were billing nurse visits and/or injection administrations when performed by the physician practice nurse. Now that the nurse in employed by the facility, are we still able to bill the nurse visit? Provider based billing rules are tricky, and so far the answer I think I found is no, because they are not "from the same employer/entity". Has anyone run into this issue? also to complicate the rules, the physician practice may lease blocks of RN time. How does that factor into professional service billing nurse visits?
here are my resources
www.cms.hhs.gov/transmittals/downloads/R1776B3.pdf
https://www.law.cornell.edu/cfr/text/42/413.65
Thank you
here are my resources
www.cms.hhs.gov/transmittals/downloads/R1776B3.pdf
https://www.law.cornell.edu/cfr/text/42/413.65
Thank you