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Posted By Mary Peabody on 04-20-2020, 19:16:05 in Ob-Gyn
Hello Melanie,

If the NP sees the patient as a shared visit with the physician and the NP documents that she spent 20 minutes face to face with patient and the physician documents that he spent 20 minutes with the patient and greater 50% is spent in counseling, can both the 20 minutes with the NP and the 20 minutes with the physician be combined to select the level of service (example 99214)?
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Posted By Melanie Witt on 04-21-2020, 17:03:04
Per Medicare (the ones who have published the guidelines for shared/split visit:
In the office/clinic setting when the physician performs the E/M service the service must be reported using the physician’s UPIN/PIN. When an E/M service is a shared/split counter between a physician and a non-physician practitioner (NP, PA, CNS or CNM), the service is considered to have been performed “incident to” if the requirements for “incident to” are met and the patient is an established patient. If “incident to” requirements are not met for the shared/split E/M service, the service must be billed
under the NPP’s UPIN/PIN, and payment will be made at the appropriate physician fee schedule payment.
And under Medicare rules time is physician time only so you have a problem here is this was performed in the office. First, it would have to be billed as an incident to service, and second you can only use the 20 minutes documented by the physician.
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