CME OnDemand: Crack the Codes Practice Management and Coding-Recording: PA & NP Billing Strategies

Video Transcription

Video Summary

The video is a presentation on PA and NP billing strategies for both the office and hospital settings. The presenters, Jennifer Cabrera and Jennifer Bell, discuss three different billing options: incident-to billing, direct billing, and split-shared billing. Incident-to billing refers to a service provided by a non-physician provider that is billed by the physician using their NPI number. This option has higher reimbursement but comes with certain restrictions. Direct billing, on the other hand, involves the PA or NP billing under their own NPI number, with lower reimbursement but fewer restrictions. Split-shared billing is a newer option where the PA or NP and physician jointly provide a service and the billing is determined by who performs the substantial portion of the visit. The presenters highlight the criteria for each billing option and discuss scenarios to illustrate how to determine which option is appropriate. They also mention changes in split-shared billing for 2023 and 2024. The presentation concludes with a Q&A session. The video is part of the Crack the Code Practice Management and Coding Course Series, which is funded by the Orthopedic Foot and Ankle Foundation and supported by grants from Paragon 28.

Keywords

billing strategies

incident-to billing

direct billing

split-shared billing

reimbursement

NPI number

Q&A session