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Master Advanced Practice Provider Billing


About this program


Medicare reimburses advanced practice providers (APP) for services that are ‘incident to’ a physician’s service with defined guidelines. When billed correctly, these services are reimbursable at 100 percent of the physician’s fee schedule. Improve your understanding of Medicare and third-party guidelines for APP service billing to reduce audit risk.

Learn the differences in APPs, NPs, PAs, RNs, CNMs, CRNAs, scope of practice and protocols. Review important details on split/shared billing, utilization of APPs in alternate healthcare settings, and collaborative agreement arrangements. Receive expert guidance on documentation requirements needed to support claims, cross-checking and code selection, and how to avoid under-coding.

Highlights

  • Distinguish when to bill under the provider initializing care vs the supervising provider
  • Incident-to billing requirement
  • Requirements for billing shared/split visits
  • Reimbursement for provider-based vs. office-based facilities