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Thread: 3 part question - consults performed for Medicare patients

  1. #1

    Default 3 part question - consults performed for Medicare patients

    AAPC: Back to School
    Does your practice schedule consults and/or new patient visits for patients who have medicare/medicaid with just your physicians?

    Or do you also schedule these patients with your PA's?

    If you do schedule medicare/medicaid patients for consults/new pt visits with your PA's - do you always bill under the PA alone? (even if the physician performs part of the visit?)

  2. #2


    I would appreciate any responses on how your GI practice shecdules these type of appointments.

  3. #3
    Join Date
    Apr 2007
    Greeley, Colorado


    Our GI practice does not employ an NPP. If you are looking at coding split/shared visits for the first time Medicare or Medicaid patient you should research that topic on CMS. Unfortunately I do not have that situation and don't know the rules but I do know it's on CMS or on your MAC or FI website most likely in an NPP manual. Sorry I can't be more helpful. You could try a private message to rebeccawoodward or ftessabartels on the forum. One or both has posted something before about split/shared visits. Good luck.
    Lisa Bledsoe, CPC, CPMA

  4. #4


    We do employ NPP's and according to the CMS/Medicare guidelines consults cannot be shared/split. They must either be in the NPP name or the Doctor name but not if the NPP saw and used the Supversing or Consulting Physician. Generally we try to avoid scheduline genuine consults with NPP's and give them the new patient visits. All of that is handled when the call is made to schedule the appointment.
    Kimm Hall CPC, CMSCS, CGCS

    If you live to regret then you have not learned lifes lessons.

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