2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing (On-Demand) | November 2021-Update on Advanced Practitioner Billing: Incident-to and Split-Shared Services

Video Transcription

Video Summary

In this video, the speaker discusses the topic of advanced practitioner billing incident two and split shared services. They explain that advanced practice providers, such as physician assistants and nurse practitioners, are considered billing providers who must meet certain guidelines when billing a service under a physician. The speaker goes on to define incident two services as part of a patient's normal course of treatment during which the physician remains actively involved, but does not have to be present in the room. However, the physician must be in the clinic that day. They emphasize the importance of billing correctly for incident two services and provide examples of scenarios that meet or do not meet the criteria. The speaker also discusses shared services, in which a physician and an advanced practice provider in the same group provide care together. They explain that the substantive portion of the visit must be performed by the physician, at least until 2023, when more than half of the total time spent will define the substantive portion. The speaker provides examples of documentation that supports shared visits and explains the need for a modifier and documentation to identify shared services on claims. They note that different payers may have different guidelines and suggest keeping track of payer policies and guidelines. The video concludes by recommending understanding and following the specific guidelines of the payer when billing incident two and shared services.

Asset Subtitle

Kristin Vaughn, CPC, QMC, QMGC, CPMA, ICDCT-CM

Keywords

advanced practitioner billing

incident two

split shared services

physician assistants

nurse practitioners

billing providers