Billing for Nurse Practitioner (NP) and Physician Assistant (PA) Services: Mastering the Latest Guidelines and Compliance Strategies

Simplifying Split Shared Visits, CMS Regulations, and Payer Rules for Non-Physician Practitioner Billing

Billing for Nurse Practitioners and Physician Assistants can be a challenging maze to navigate, with each payer having its own rules for direct and indirect services. These variations lead to a confusing array of compliance requirements for billing indirect services, making it difficult to ensure proper billing practices.

Recent updates bring significant changes to how “substantive portion” is defined in split shared visits, especially in facility settings. With new policies now aligning with the latest CPT® guidelines, understanding these rules is crucial to staying compliant. Learn what these changes mean for your practice and how to ensure your billing processes are up to date.

What You’ll Learn:

• Overcome NPP Billing Challenges: Grasp the complexities of billing for NPs and PAs, navigating the varying rules and definitions set by different payers.
• Understand the Latest CPT® Updates: Dive deep into the latest guidelines on split shared billing and uncover the practical documentation changes required for compliance.
• Unravel CMS’ Take on Split Shared Billing: Explore the evolving CMS guidelines on split shared visits and the “substantive portion” rule, along with its impact on your billing processes.
• Navigate “Incident To” Billing Requirements: Break down the key points in CMS’ updated guidelines and ensure your billing practices meet current standards.
• Master Payer-Specific Billing Rules: Understand how different payers’ rules affect billing compliance and learn strategies to adapt and remain compliant.

Key Discussion Points:

• New Split Shared Billing Definition: Discover the latest CPT® updates and how the definition of split shared billing is evolving.
• Daily Documentation Adjustments: Learn about the documentation changes needed to meet the new guidelines and how to integrate them seamlessly into your practice.
• CMS vs. CPT – Navigating the Differences: Compare the differing definitions and requirements from CMS and CPT, and learn strategies for dealing with these complexities.
• Addressing Compliance Challenges: Gain insights into overcoming challenges posed by different interpretations of split shared billing and how to ensure billing accuracy across the board.

Who Should Attend:

Coders, Billers, Office Managers, Office Administrators, Nurse Practitioners, Physician Assistants – anyone involved in the billing and compliance of NP and PA services.

This comprehensive session will equip you with the knowledge and strategies needed to navigate the intricate world of NP and PA billing, ensuring you stay compliant and ahead of the curve in the evolving healthcare landscape.