Results 1 to 6 of 6

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
    Default
    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
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    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
    Default
    Thanks for the assistance!!!


    JULIE M. SHAFER

Similar Threads

  1. aprn
    By baran in forum Payer/Health Plan
    Replies: 1
    Last Post: 03-04-2015, 05:38 PM
  2. Billing an APRN
    By courtneyb in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 09-20-2012, 08:54 AM
  3. Billing for an APRN
    By armymomryan in forum Modifiers
    Replies: 0
    Last Post: 08-18-2010, 07:14 AM
  4. Billing for APRN
    By armymomryan in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-18-2010, 07:13 AM
  5. APRN/PA billing
    By kfenton in forum E/M
    Replies: 1
    Last Post: 11-18-2008, 05:00 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.