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Thread: Help! Dr hiring NP!

  1. #1
    Join Date
    Apr 2007

    Default Help! Dr hiring NP!

    AAPC: Back to School
    My dr is getting ready to go on maternity leave and want to hire a nurse pracitioner while she is gone to handle all her patients. Now she is a one dr practice, Can she have NP seeing patients if she isn't there supervising? We are in the state of TX and I can't seem to find any laws stating the dr has to be at the office. Please help! thanks!

  2. #2
    Join Date
    Apr 2007
    Evansville Indiana

    Default NP

    If the NP is going to be billing under the MD's NPI and the payer is Medicare, Medicaid or any payer that follows CMS "incident to" guidelines, the physician must be in the office. If the NP is billing under their own NPI,"incident to" guidelines do not need to be followed.
    I would also look up your State scope of practice for NP's. There are often many rules to follow, such as a collaborative agreement. Make sure you do your research well in advance of the hiring.


  3. #3
    Join Date
    Apr 2007


    coding for the NP goes so much easier if they have their own NPI so you can avoid the "incident to" rules...it's definately worth it!

  4. #4


    I have another question for you all....

    Say it is a two physician practice. Dr Smith performs the initial visit and develops the plan of care. Then the patient comes in and is seen by the PA - so we can bill "incident to" if Dr Smith is on site. Now what if Dr Smith is out of the office, and his partner Dr Jones is in the office supervising the PA. Since Dr Smith developed the plan of care, can we still bill "incident to" under Dr Smith, even though it is Dr Jones in the office that day?

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