Unraveling Split Shared Visits, CMS Guidelines, and Payer Rules for Non-Physician Practitioner Billing
The rules of billing for Nurse Practitioners and Physician Assistants can be confusing and challenging. Each payer can have their own definitions for direct and indirect billing of their services. Comparing these rules reveals a diverse and often times confusing list of what compliant billing of these provider’s indirect services entails.
CMS/Medicare and CPT have been in different places with their definition of "substantive portion" for a split shared visit. It was anticipated that in 2024 CMS/Medicare would again have a different way of looking at which provider can bill this type of joint service when done in a facility setting. The PFS Final rule surprised many as CMS/Medicare said they would be following the new clarified policy set forth in CPT's 2024 code book. What is this new definitions of "substantive portion" and what does it mean for your NPs and PAs working in the hospital and other facility based locations? Listen in and learn. Bring your questions with you.
Webinar Objectives
- Navigate NPP Billing Challenges:
- Comprehend the intricacies and challenges associated with billing rules for NPs and PAs, considering the diverse definitions presented by various payers.
- Decode CPT® 2024 Updates:
- Gain a comprehensive understanding of the new guidelines for split shared billing introduced in the CPT® 2024 updates.
- Explore the AMA's perspective on these guidelines and understand the necessary day-to-day documentation changes for compliance.
- Unpack CMS' Perspective on Split Shared Billing:
- Analyze CMS' evolving definition of split/shared visits, particularly the emphasis on a "substantive portion" and its implications for billing providers.
- Address challenges arising from the differing terminology used by CMS and CPT.
- Navigate CMS Guidelines for Incident To Billing
- Gain insights into CMS' guidelines for split shared visits in 2024, including the nuanced requirements for "incident to" billing.
- Ensure a clear understanding of compliance standards set forth by CMS.
- Master Other Payers' Rules for NPP Billing:
- Explore rules and regulations established by various payers for the billing of NPP services.
- Understand how these rules interact with and influence the broader landscape of billing compliance for NPs and PAs.
Webinar Agenda
- Understanding the New Definition from the AMA:
- Explore the 2024 CPT® updates and delve into the evolving definition of split shared billing.
- Gain insights into the perspective of the American Medical Association (AMA) and their vision for day-to-day documentation changes required to align with the new definition.
- AMA's Perspective on Day-to-Day Documentation Changes:
- Break down the AMA's expectations regarding the daily documentation changes necessary to adhere to the redefined split shared billing concept.
- Discuss practical insights and guidelines provided by the AMA to ensure seamless compliance with the updated CPT® standards.
- Defining Split Shared Billing according to CMS:
- Examine the split shared billing definition as articulated by the Centers for Medicare & Medicaid Services (CMS).
- Understand the nuances and distinctive features highlighted by CMS in their interpretation of split shared billing, comparing it with the AMA's viewpoint.
- Navigating Challenges Arising from Varied Definitions:
- Identify and analyze the challenges presented by the differing perspectives and terminology used by the AMA and CMS in defining split shared billing.
- Discuss strategies for addressing these challenges to ensure effective and compliant billing practices.
Webinar Highlights
- The new guidelines for split shared visits found in CPT® 2024
- CMS’ guidelines for split shared in2024
- CMS’ guidelines for incident to
- Other payers’ rules and regulations for Non-Physician Practitioner billing
Who Should Attend
Coders,Billers, Office Managers, Office Administrators, Nurse Practitioners, Physician Assistants
