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Thread: Billing for services provided by NP students

  1. #1
    Join Date
    Apr 2007

    Question Billing for services provided by NP students

    AAPC: Back to School
    I am hoping someone can help me with this one.

    I did an audit of a provider and discovered they had a NP student in the office a couple days a week seeing patients. I told them we can not bill for services provided by a student and we need to refund anything that was paid on these services that were blind billed as if the doctor provided the service.

    My doctor was ok with this, another doctor in the office (different practice they just share the same space) jumped all over me last week about this. He told me that I was costing them a lot of money and don't know what I am talking about. He states that NP students are the same as residents.

    My thoughts, which I somehow managed to keep to myself, are if you want to commit fraud that is on you, but any doctor working for us is going to follow the rules. I have teaching physicians, I have a lot of residents. I do not have NP students and I do not know all the ins and outs to what they can and can not do. The CMS guidelines seem pretty clear in that anyone still classified as a student can not be treated the same as a resident. Is there anything else out there that states otherwise? I have emailed the AANP but have not received a response yet.


    Laura, CPC, CPMA, CEMC

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default NP student is NOT licensed

    A resident is a licensed physician who is still continuing postgraduate training.

    An NP student is NOT yet licensed to practice independently of a physician.

    Definitely NOT the same thing as a resident.

    Your state licensing board may be able to give you additional guidance.

    Now, to further complicate matters ... we sometimes have a licensed NP who is getting ADDITIONAL specialty training ... that person IS billable EXCEPT for procedures/services that are part of his/her advanced training. (More akin to our fellows than to students.) But I don't think that's the scenario you are dsecribing.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Join Date
    Apr 2007
    Louisville, KY


    Nope. Your providers' decision to utilize NP Students and failure to pro-actively address this with Coding is what is costing money to the practice. The supervision guidelines are not the same for students as for Residents. I've attached the Medicare Teaching Guidelines for your assistance.

    Good luck to you.

    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

  4. #4
    Join Date
    Apr 2007

    Default Thank you so much

    It is nice to know I'm not crazy!

    The really scary thing is the doctor that stated this is a medical director in addition to his private practice.

    Laura, CPC, CPMA, CEMC

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