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Nurse practitioner supervising infusions

  1. #1
    Default Nurse practitioner supervising infusions
    Medical Coding Books
    Can a nurse practitioner oversee an infusion suite in a providers office without a supervising physician present in the office? I have tried to research this on my state's website and cannot find a definitive answer. She would be billing using her own Medicare number, obviously because this would not be incident-to.

  2. Default Nurse Practioner overseeing infusion
    PAs and nurse practioners should have their own NPI number with MDCR.This allows them to bill under their own number when not billing 'incident to'.When they bill independently for MDCR they are pd at 85% for all professional svcs. Drugs are not impacted. Drugs are paid the same no matter who is treating the patient.
    Tricia D., RHIT, CCS-P, CPC, CHONC

  3. #3
    Default
    Thank you, I understand that she would be reimbursed for the medication administered,my question has to do with the legalities of her being the only provider available in the physician's office while infusions are taking place. I have read conflicting info that states that a physician must be present during IV infusions in a physician's office when chemotherapy or other specific drugs such as those used for rheumatoid arthritis are being used. The codes used to bill the administration are 96413 and 96415. Any thoughts?

    Thank you

  4. Default NP
    I think for the most part it will depend on which payor you are referring to. I bill out under the NP and PA but the only ones who need a different billing "supervising" MD would be for Tricare or Medicaid, those are the only two where I have to pay attention to who is doing what.

  5. Default
    Quote Originally Posted by ilenefla View Post
    Thank you, I understand that she would be reimbursed for the medication administered,my question has to do with the legalities of her being the only provider available in the physician's office while infusions are taking place. I have read conflicting info that states that a physician must be present during IV infusions in a physician's office when chemotherapy or other specific drugs such as those used for rheumatoid arthritis are being used. The codes used to bill the administration are 96413 and 96415. Any thoughts?

    Thank you
    When I get conflicting information, I call the payor or payors involved. Someone in your local chapter may be able to answer the question as well.

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