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Billing for NPPs

  1. #1
    Default Billing for NPPs
    Medical Coding Books
    Hello any and all,
    I have been digging into this question for some time. Here is my scenario: We recently hired a NPP at our family practice. She is a Registered Dietician, Licensed Dietician, and a Certified Diabetic Educator. We are trying to figure out the best way to encorporate her into our billing process. She is spending close to an hour in consultation managing diet and nutrition in patients with chronic diseases such as diabetes, hypertension, and hyperlipidemia.
    Now my conflict: The most info that I have been able to gather states that (according to Medicare) due to her credentials she is only able to bill for a 99211. Due to the time that is needed for her consultations versus the reimbursement for what we can bill (99211) makes this a losing proposition for a service that is important for the health and compliance of our patients.

    So, what I'd like to ask is if anyone has any info (possibly documentation) on how this can legally and fairly be billed so our clinic is not taking a loss on each encounter. We would like to continue to provide this service.

    Thank you very much to any and all responses.

  2. #2
    is she seeing new patients? if so, are you billing under her provider #??
    Dawnelle Beall, CPC, CPMA, CPC-I
    Licensed AAPC PMCC Instructor
    AAPC ICD-10CM Certified Trainer
    Previous AAPC Local Chapter President & VP

  3. #3
    Default Medical Nutrition Therapy
    Did you take a look at the Medical Nutritional Therapy codes in CPT: 97802 and 97803?
    In addition there are HCPCS codes: G0270 & G0271 for MNT. You should check with your local Medicare carrier, since there are frequency rules with MNT codes.
    E. Frohna
    Menomonee Falls, WI
    Evangelina Frohna, CPC, CEMC

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