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APRN on her own??

  1. #1
    Red face APRN on her own??
    Medical Coding Books
    My physician is cancelling out a day for personal reason however this leaves only the APRN to see patients that day. My understanding of CMS guidelines is the Dr. must be in the office or immediately available to perform care if necessary. HELP.

  2. Default APRN On Her Own??
    From what I understand, for Incident-To Services, one of the five criterias is that the physician must be under direct supervision (in suite and immediately available).

    This is set forth by Medicare and most commercial carriers follow this.

  3. #3
    What if she is credentialed with Medicare though and we are billing under her own ID?

  4. Default APRN On Her Own??
    Looking at my notes and handouts that I received at the CE I took, services of non-physician practitioners may bill services as "incident-to" providing the criterias are met (one of them being physician in suite).

    If it's not being billed as incident-to, I don't have an answer.

    Sorry, I'm relatively new at this.

  5. #5
    Sioux Falls South Dakota
    If she is credentialed with Medicare on her own, she can bill under her own NPI without a physician in the office suite, unless it is not in the scope of her practice according to your state.

    So, be sure to check what your state allows; you would also have to make sure she is credentialed to bill your other insurance carriers before booking any of their patients with her.

    I hope this helps,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  6. #6
    Thanks for the assistance!!!


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