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Thread: Question?? Medicare & billing for nurse practitioner

  1. #1
    Join Date
    Apr 2007

    Default Question?? Medicare & billing for nurse practitioner

    AAPC: Back to School
    Is it required that a patient have at least one face to face visit with the dr before a treatment path begins for Medicare billing? Also what codes should be used if the nurse practitioner does all visits but the dr signs off on the chart?

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    You do not have to have the physician see the patient first as long as you bill using the NPs NPI number. If she sees a new problem or new patient you must bill using her NPI number. The physician signing off is not sufficient to bill under his number. See CR 1776.. which states if there is no face to face encounter between the provider and the patient , even if the physician signs off on the documentation, then the visit must be bill using the NPPs number.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007


    Thank you so much! This helps a great deal.

  4. #4


    In order to bill incident to services, the dr. must establish the plan of care or treatment plan, so if you ever intend to bill incident to, the dr does have to see the patient.

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